How much rates vary
Facilitymedian $2,239 · 10th to 90th $933 to $10,000Professionalmedian $427 · 10th to 90th $110 to $676
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 $426.58 Median $10,964.78 Typical High $21,877.62 | Facility | None | $426.58 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $489.78 | Professional | None | $371.54 | $426.58 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $2,691.53 Typical High $8,128.31 | Facility | None | $1,202.26 | $2,691.53 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $616.60 | Professional | None | $323.59 | $426.58 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $3,162.28 | Facility | None | $602.56 | $1,905.46 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $707.95 | Professional | None | $354.81 | $416.87 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $426.58 Median $891.25 Typical High $1,380.38 | Facility | None | $426.58 | $891.25 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $575.44 | Professional | None | $380.19 | $457.09 | $575.44 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $398.11 Typical High $691.83 | Professional | None | $81.28 | $398.11 | $691.83 |
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 $346.74 Median $457.09 Typical High $812.83 | Professional | None | $346.74 | $457.09 | $812.83 |
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 $186.21 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $186.21 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $275.42 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $54.95 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $42.66 Typical High $48.98 | Professional | 56 · Pre-op care only | $37.15 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $257.04 | $302.00 | $346.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $229.09 Typical High $380.19 | Professional | 51 · Multiple procedures | $190.55 | $229.09 | $380.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $91.20 Typical High $154.88 | Professional | 80 · Assistant surgeon | $77.62 | $91.20 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $53.70 Median $64.57 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $53.70 | $64.57 | $107.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $53.70 Median $64.57 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $53.70 | $64.57 | $107.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $64.57 Typical High $107.15 | Professional | AS · PA/NP assist | $53.70 | $64.57 | $107.15 |
Where South Carolina sits
The same service costs 4.3 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· 35th of 51
$468
AK $1,380UT $324
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.