How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $8,511Professionalmedian $776 · 10th to 90th $178 to $1,288
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 $1,023.29 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,023.29 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | None | $870.96 | $1,023.29 | $1,023.29 |
BCBS South Carolina Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,318.26 | Professional | None | $776.25 | $794.33 | $1,318.26 |
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 $851.14 Median $954.99 Typical High $1,621.81 | Professional | None | $851.14 | $954.99 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $2,454.71 | Facility | None | $758.58 | $1,023.29 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,258.93 | Professional | None | $977.24 | $1,071.52 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $602.56 Typical High $1,230.27 | Professional | None | $162.18 | $602.56 | $1,230.27 |
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 $831.76 Median $1,047.13 Typical High $1,778.28 | Professional | None | $831.76 | $1,047.13 | $1,778.28 |
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 $436.52 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $724.44 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $537.03 Typical High $794.33 | Professional | 51 · Multiple procedures | $489.78 | $537.03 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $213.80 Typical High $316.23 | Professional | 80 · Assistant surgeon | $194.98 | $213.80 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $147.91 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $138.04 | $147.91 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $147.91 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $147.91 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $147.91 Typical High $223.87 | Professional | AS · PA/NP assist | $138.04 | $147.91 | $223.87 |
Where South Carolina sits
The same service costs 6.6 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· 46th of 51
$776
AK $2,884TX $437
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.