How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,950 · 10th to 90th $295 to $3,162
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 $2,187.76 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,187.76 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,819.70 | $2,187.76 | $2,187.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,737.80 | $1,949.84 | $3,235.94 |
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 $1,862.09 Median $2,089.30 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,089.30 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $5,128.61 | Facility | None | $1,479.11 | $2,187.76 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,019.95 | Professional | None | $1,995.26 | $2,344.23 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $1,905.46 Typical High $3,162.28 | Professional | None | $245.47 | $1,905.46 | $3,162.28 |
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 $1,621.81 Median $2,089.30 Typical High $3,715.35 | Professional | None | $1,621.81 | $2,089.30 | $3,715.35 |
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 $912.01 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $912.01 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,380.38 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $181.97 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,548.82 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,096.48 Median $1,174.90 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $1,096.48 | $1,174.90 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $467.74 Typical High $660.69 | Professional | 80 · Assistant surgeon | $436.52 | $467.74 | $660.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $331.13 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $302.00 | $331.13 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $331.13 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $331.13 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $331.13 Typical High $467.74 | Professional | AS · PA/NP assist | $302.00 | $331.13 | $467.74 |
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· 40th of 51
$1,950
AK $7,762TX $1,318
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.