How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,514 to $18,197Professionalmedian $692 · 10th to 90th $100 to $1,230
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $812.83 Median $9,120.11 Typical High $20,417.38 | Facility | None | $812.83 | $9,120.11 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,122.02 | Professional | None | $724.44 | $812.83 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $1,174.90 | Professional | None | $537.03 | $891.25 | $1,174.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,041.74 Median $6,165.95 Typical High $18,197.01 | Facility | None | $2,041.74 | $6,165.95 | $18,197.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $645.65 Median $1,230.27 Typical High $1,995.26 | Professional | None | $645.65 | $1,230.27 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $4,570.88 | Facility | None | $630.96 | $3,235.94 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,479.11 | Professional | None | $794.33 | $891.25 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,047.13 Typical High $3,715.35 | Facility | None | $794.33 | $1,047.13 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,288.25 | Professional | None | $851.14 | $1,047.13 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $575.44 Typical High $1,071.52 | Professional | None | $85.11 | $575.44 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,786.30 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,786.30 | $24,547.09 |
United Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,513.56 | Professional | None | $691.83 | $870.96 | $1,513.56 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $575.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $524.81 Typical High $691.83 | Professional | 51 · Multiple procedures | $457.09 | $524.81 | $691.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $208.93 Typical High $275.42 | Professional | 80 · Assistant surgeon | $181.97 | $208.93 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $147.91 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $128.82 | $147.91 | $194.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $147.91 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $147.91 | $194.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $147.91 Typical High $194.98 | Professional | AS · PA/NP assist | $128.82 | $147.91 | $194.98 |
Where South Carolina sits
The same service costs 4.5 times more in Alaska than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $10,099MT $2,245
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.