How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $2,239 · 10th to 90th $331 to $3,715
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 $2,691.53 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,691.53 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,238.72 | $2,691.53 | $2,691.53 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $4,168.69 | Professional | None | $2,089.30 | $2,570.40 | $4,168.69 |
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 $2,454.71 Median $2,754.23 Typical High $5,011.87 | Professional | None | $2,454.71 | $2,754.23 | $5,011.87 |
Medcost Setting Facility Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $6,309.57 | Facility | None | $1,862.09 | $2,691.53 | $6,309.57 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $4,365.16 | Professional | None | $2,570.40 | $2,951.21 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $309.03 Median $1,949.84 Typical High $3,715.35 | Professional | None | $309.03 | $1,949.84 | $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 $2,137.96 Median $2,630.27 Typical High $4,570.88 | Professional | None | $2,137.96 | $2,630.27 | $4,570.88 |
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 $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,122.02 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,659.59 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $338.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,862.09 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,348.96 Median $1,479.11 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $1,348.96 | $1,479.11 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $588.84 Typical High $870.96 | Professional | 80 · Assistant surgeon | $537.03 | $588.84 | $870.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $416.87 Typical High $616.60 | Professional | 81 · Minimal assistant surgeon | $371.54 | $416.87 | $616.60 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $416.87 Typical High $616.60 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $416.87 | $616.60 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $416.87 Typical High $616.60 | Professional | AS · PA/NP assist | $371.54 | $416.87 | $616.60 |
Where South Carolina sits
The same service costs 7.6 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· 44th of 51
$2,239
AK $9,550TX $1,259
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.