How much rates vary
Facilitymedian $1,047 · 10th to 90th $437 to $8,511Professionalmedian $1,413 · 10th to 90th $214 to $2,399
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 $1,737.80 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,737.80 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,737.80 | $1,737.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,513.56 | $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 $1,380.38 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,380.38 | $1,584.89 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $4,073.80 | Facility | None | $1,047.13 | $1,737.80 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,698.24 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,288.25 Typical High $2,398.83 | Professional | None | $199.53 | $1,288.25 | $2,398.83 |
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 $1,148.15 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,584.89 | $2,884.03 |
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 $724.44 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $724.44 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $288.40 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,071.52 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $218.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,202.26 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $851.14 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $776.25 | $851.14 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $338.84 Typical High $602.56 | Professional | 80 · Assistant surgeon | $309.03 | $338.84 | $602.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $234.42 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $213.80 | $234.42 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $234.42 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $234.42 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $234.42 Typical High $426.58 | Professional | AS · PA/NP assist | $213.80 | $234.42 | $426.58 |
Where South Carolina sits
The same service costs 8.5 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· 43rd of 51
$1,413
AK $6,166TX $724
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.