How much rates vary
Facilitymedian $1,000 · 10th to 90th $513 to $7,943Professionalmedian $1,288 · 10th to 90th $240 to $2,138
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 $1,412.54 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,412.54 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,412.54 | $1,412.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,258.93 | $2,344.23 |
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 $1,230.27 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,380.38 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $3,388.44 | Facility | None | $891.25 | $1,412.54 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,445.44 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $1,258.93 Typical High $2,089.30 | Professional | None | $204.17 | $1,258.93 | $2,089.30 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,288.25 Typical High $8,511.38 | Facility | None | $512.86 | $1,288.25 | $8,511.38 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,380.38 | $2,398.83 |
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 $588.84 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $1,000.00 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $724.44 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $707.95 | $724.44 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $288.40 Typical High $436.52 | Professional | 80 · Assistant surgeon | $281.84 | $288.40 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $199.53 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $194.98 | $199.53 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $199.53 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $199.53 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $199.53 Typical High $302.00 | Professional | AS · PA/NP assist | $194.98 | $199.53 | $302.00 |
Where South Carolina sits
The same service costs 5.6 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· 42nd of 51
$1,288
AK $5,012TX $891
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.