How much rates vary
Facilitymedian $1,950 · 10th to 90th $759 to $10,000Professionalmedian $417 · 10th to 90th $66 to $661
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 $478.63 Median $10,000.00 Typical High $21,877.62 | Facility | None | $478.63 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | None | $436.52 | $478.63 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,344.23 Typical High $8,128.31 | Facility | None | $851.14 | $2,344.23 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $812.83 | Professional | None | $371.54 | $489.78 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $870.96 | Professional | None | $436.52 | $457.09 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $741.31 Typical High $1,698.24 | Facility | None | $478.63 | $741.31 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $977.24 | Professional | None | $467.74 | $537.03 | $977.24 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $338.84 Typical High $630.96 | Professional | None | $60.26 | $338.84 | $630.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $870.96 | Professional | None | $398.11 | $501.19 | $870.96 |
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 $213.80 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $323.59 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $302.00 | $338.84 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $263.03 Typical High $489.78 | Professional | 51 · Multiple procedures | $263.03 | $263.03 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $107.15 Typical High $199.53 | Professional | 80 · Assistant surgeon | $104.71 | $107.15 | $199.53 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $74.13 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $74.13 | $74.13 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $74.13 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $74.13 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $74.13 Typical High $138.04 | Professional | AS · PA/NP assist | $74.13 | $74.13 | $138.04 |
Where South Carolina sits
The same service costs 7.1 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
$479
AK $2,042UT $288
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.