How much rates vary
Facilitymedian $955 · 10th to 90th $457 to $8,511Professionalmedian $372 · 10th to 90th $224 to $550
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 $371.54 Median $5,888.44 Typical High $21,877.62 | Facility | None | $371.54 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $478.63 | Professional | None | $331.13 | $371.54 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS South Carolina Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $724.44 | Professional | None | $288.40 | $407.38 | $724.44 |
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 $354.81 Median $371.54 Typical High $676.08 | Professional | None | $354.81 | $371.54 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $295.12 Median $371.54 Typical High $933.25 | Facility | None | $295.12 | $371.54 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $724.44 | Professional | None | $389.05 | $446.68 | $724.44 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $346.74 Typical High $537.03 | Professional | None | $66.07 | $346.74 | $537.03 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $8,511.38 | Facility | None | $512.86 | $1,288.25 | $8,511.38 |
United Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $676.08 | Professional | None | $316.23 | $398.11 | $676.08 |
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 $165.96 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $66.07 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $263.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $223.87 Typical High $363.08 | Professional | 51 · Multiple procedures | $204.17 | $223.87 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $89.13 Typical High $144.54 | Professional | 80 · Assistant surgeon | $81.28 | $89.13 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $63.10 Typical High $100.00 | Professional | 81 · Minimal assistant surgeon | $57.54 | $63.10 | $100.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $63.10 Typical High $100.00 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $63.10 | $100.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $63.10 Typical High $100.00 | Professional | AS · PA/NP assist | $57.54 | $63.10 | $100.00 |
Where South Carolina sits
The same service costs 5.8 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· 45th of 51
$372
AK $1,380UT $240
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.