How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,413 · 10th to 90th $214 to $2,344
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 $1,659.59 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,659.59 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,659.59 | $1,659.59 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,412.54 | $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 $1,513.56 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,737.80 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $3,981.07 | Facility | None | $1,122.02 | $1,659.59 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,819.70 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,230.27 Typical High $2,344.23 | Professional | None | $199.53 | $1,230.27 | $2,344.23 |
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 $1,318.26 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,659.59 | $2,818.38 |
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 $691.83 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $2,691.53 Typical High $4,365.16 | Professional | 50 · Both sides | $2,511.89 | $2,691.53 | $4,365.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $912.01 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $831.76 | $912.01 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $363.08 Typical High $575.44 | Professional | 80 · Assistant surgeon | $331.13 | $363.08 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $251.19 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $234.42 | $251.19 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $251.19 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $251.19 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $251.19 Typical High $407.38 | Professional | AS · PA/NP assist | $234.42 | $251.19 | $407.38 |
Where South Carolina sits
The same service costs 7.8 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· 45th of 51
$1,413
AK $5,888TX $759
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.