How much rates vary
Facilitymedian $2,138 · 10th to 90th $631 to $17,378Professionalmedian $912 · 10th to 90th $158 to $1,514
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 $1,000.00 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,000.00 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | None | $891.25 | $1,000.00 | $1,000.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
BCBS South Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $2,290.87 | Professional | None | $776.25 | $1,096.48 | $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 $977.24 Median $1,000.00 Typical High $1,819.70 | Professional | None | $977.24 | $1,000.00 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,737.80 | Facility | None | $831.76 | $1,096.48 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,230.27 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $812.83 Typical High $1,348.96 | Professional | None | $123.03 | $812.83 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,090.30 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,862.09 | Professional | None | $851.14 | $1,071.52 | $1,862.09 |
12 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 $446.68 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $181.97 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $707.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,862.09 Typical High $2,754.23 | Professional | 50 · Both sides | $1,698.24 | $1,862.09 | $2,754.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $616.60 Typical High $912.01 | Professional | 51 · Multiple procedures | $562.34 | $616.60 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $245.47 Typical High $363.08 | Professional | 80 · Assistant surgeon | $223.87 | $245.47 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $173.78 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $158.49 | $173.78 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $173.78 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $173.78 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $173.78 Typical High $257.04 | Professional | AS · PA/NP assist | $158.49 | $173.78 | $257.04 |
Where South Carolina sits
The same service costs 6.3 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
$955
AK $3,715UT $589
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.