How much rates vary
Facilitymedian $1,259 · 10th to 90th $457 to $9,333Professionalmedian $1,148 · 10th to 90th $174 to $1,862
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 $1,380.38 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,380.38 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,380.38 | $1,380.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,412.54 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,380.38 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $3,388.44 | Facility | None | $1,122.02 | $1,380.38 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,698.24 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $954.99 Typical High $1,819.70 | Professional | None | $162.18 | $954.99 | $1,819.70 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,479.11 | $2,570.40 |
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 $616.60 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $851.14 | $954.99 | $954.99 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $851.14 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $776.25 | $851.14 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $338.84 Typical High $446.68 | Professional | 80 · Assistant surgeon | $309.03 | $338.84 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $234.42 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $218.78 | $234.42 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $234.42 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $234.42 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $234.42 Typical High $309.03 | Professional | AS · PA/NP assist | $218.78 | $234.42 | $309.03 |
Where South Carolina sits
The same service costs 7.1 times more in Alaska than in Texas. 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.
South Carolina· 47th of 51
$1,148
AK $5,012TX $708
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.