How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $8,511Professionalmedian $977 · 10th to 90th $155 to $1,698
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 $1,174.90 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,174.90 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | None | $977.24 | $1,174.90 | $1,174.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $1,445.44 | Professional | None | $954.99 | $977.24 | $1,445.44 |
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 $1,023.29 Median $1,122.02 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,122.02 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $2,754.23 | Facility | None | $724.44 | $1,174.90 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,148.15 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $891.25 Typical High $1,698.24 | Professional | None | $134.90 | $891.25 | $1,698.24 |
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 $912.01 Median $1,122.02 Typical High $1,949.84 | Professional | None | $912.01 | $1,122.02 | $1,949.84 |
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 $489.78 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $147.91 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $812.83 | $812.83 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 58 · Staged procedure | $263.03 | $263.03 | $263.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $575.44 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $575.44 | $575.44 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $229.09 Typical High $446.68 | Professional | 80 · Assistant surgeon | $229.09 | $229.09 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $162.18 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $158.49 | $162.18 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $162.18 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $162.18 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $162.18 Typical High $309.03 | Professional | AS · PA/NP assist | $158.49 | $162.18 | $309.03 |
Where South Carolina sits
The same service costs 18.6 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· 45th of 51
$977
AK $4,169TX $224
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.