How much rates vary
Facilitymedian $955 · 10th to 90th $457 to $9,333Professionalmedian $794 · 10th to 90th $158 to $1,202
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 $891.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $891.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | None | $794.33 | $891.25 | $891.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $933.25 | Professional | None | $575.44 | $676.08 | $933.25 |
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 $831.76 Median $870.96 Typical High $1,621.81 | Professional | None | $831.76 | $870.96 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $891.25 Typical High $2,187.76 | Facility | None | $660.69 | $891.25 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,122.02 | Professional | None | $870.96 | $1,000.00 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $724.44 Typical High $1,202.26 | Professional | None | $123.03 | $724.44 | $1,202.26 |
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 $758.58 Median $933.25 Typical High $1,621.81 | Professional | None | $758.58 | $933.25 | $1,621.81 |
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 $398.11 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $616.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $501.19 Typical High $724.44 | Professional | 51 · Multiple procedures | $436.52 | $501.19 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $199.53 Typical High $288.40 | Professional | 80 · Assistant surgeon | $173.78 | $199.53 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $141.25 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $123.03 | $141.25 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $141.25 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $141.25 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $141.25 Typical High $199.53 | Professional | AS · PA/NP assist | $123.03 | $141.25 | $199.53 |
Where South Carolina sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 46th of 51
$794
AK $3,236UT $525
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.