How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,820 · 10th to 90th $295 to $2,884
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 $1,949.84 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,949.84 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,949.84 | $1,949.84 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,584.89 | $1,819.70 | $2,884.03 |
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 $1,778.28 Median $2,041.74 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,041.74 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $4,570.88 | Facility | None | $1,380.38 | $1,949.84 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,344.23 | Professional | None | $1,862.09 | $2,089.30 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $1,737.80 Typical High $2,884.03 | Professional | None | $245.47 | $1,737.80 | $2,884.03 |
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 $1,548.82 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,548.82 | $1,949.84 | $3,311.31 |
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 $812.83 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $812.83 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,230.27 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,380.38 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $1,096.48 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $977.24 | $1,096.48 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $436.52 Typical High $588.84 | Professional | 80 · Assistant surgeon | $389.05 | $436.52 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $309.03 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $275.42 | $309.03 | $416.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $309.03 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $309.03 | $416.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $309.03 Typical High $416.87 | Professional | AS · PA/NP assist | $275.42 | $309.03 | $416.87 |
Where South Carolina sits
The same service costs 5.9 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· 39th of 51
$1,820
AK $6,918TX $1,175
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.