How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $2,291 · 10th to 90th $331 to $3,802
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 $2,754.23 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,754.23 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,754.23 | $2,754.23 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $4,073.80 | Professional | None | $2,137.96 | $2,630.27 | $4,073.80 |
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 $2,511.89 Median $2,818.38 Typical High $5,128.61 | Professional | None | $2,511.89 | $2,818.38 | $5,128.61 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $6,456.54 | Facility | None | $1,905.46 | $2,754.23 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,388.44 | Professional | None | $2,630.27 | $3,019.95 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $1,995.26 Typical High $3,715.35 | Professional | None | $309.03 | $1,995.26 | $3,715.35 |
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 $2,187.76 Median $2,691.53 Typical High $4,677.35 | Professional | None | $2,187.76 | $2,691.53 | $4,677.35 |
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 $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,148.15 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $457.09 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,698.24 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,905.46 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,380.38 Median $1,513.56 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $1,380.38 | $1,513.56 | $2,089.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $602.56 Typical High $831.76 | Professional | 80 · Assistant surgeon | $549.54 | $602.56 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $380.19 | $426.58 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $426.58 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | AS · PA/NP assist | $380.19 | $426.58 | $575.44 |
Where South Carolina sits
The same service costs 14.1 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
$2,291
AK $9,772TX $692
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.