How much rates vary
Facilitymedian $1,072 · 10th to 90th $437 to $8,511Professionalmedian $1,445 · 10th to 90th $240 to $2,344
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 $1,584.89 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,584.89 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,584.89 | $1,584.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,445.44 | $2,187.76 |
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 $1,412.54 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,621.81 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $3,715.35 | Facility | None | $1,071.52 | $1,584.89 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,698.24 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $1,412.54 Typical High $2,344.23 | Professional | None | $204.17 | $1,412.54 | $2,344.23 |
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 $1,258.93 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,548.82 | $2,691.53 |
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 $660.69 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $660.69 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,000.00 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $933.25 | $1,096.48 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $851.14 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $776.25 | $851.14 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $338.84 Typical High $478.63 | Professional | 80 · Assistant surgeon | $316.23 | $338.84 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $239.88 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $218.78 | $239.88 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $239.88 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $239.88 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $239.88 Typical High $331.13 | Professional | AS · PA/NP assist | $218.78 | $239.88 | $331.13 |
Where South Carolina sits
The same service costs 5.8 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
$1,445
AK $5,623TX $977
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.