How much rates vary
Facilitymedian $2,089 · 10th to 90th $617 to $16,982Professionalmedian $631 · 10th to 90th $100 to $1,072
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 $794.33 Median $10,000.00 Typical High $21,877.62 | Facility | None | $794.33 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | None | $707.95 | $794.33 | $794.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $870.96 | Professional | None | $524.81 | $602.56 | $870.96 |
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 $741.31 Median $776.25 Typical High $1,445.44 | Professional | None | $741.31 | $776.25 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $831.76 Typical High $1,148.15 | Facility | None | $562.34 | $831.76 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,000.00 | Professional | None | $741.31 | $851.14 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $562.34 Typical High $1,071.52 | Professional | None | $87.10 | $562.34 | $1,071.52 |
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 $676.08 Median $831.76 Typical High $1,445.44 | Professional | None | $676.08 | $831.76 | $1,445.44 |
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 $354.81 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $354.81 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,348.96 Typical High $1,905.46 | Professional | 50 · Both sides | $1,122.02 | $1,348.96 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $446.68 Typical High $630.96 | Professional | 51 · Multiple procedures | $380.19 | $446.68 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $257.04 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $123.03 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $104.71 | $123.03 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $123.03 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $123.03 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $177.83 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $177.83 |
Where South Carolina sits
The same service costs 6.9 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
$661
AK $2,884TX $417
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.