How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $2,089 · 10th to 90th $275 to $3,467
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 $2,511.89 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,511.89 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,511.89 | $2,511.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,949.84 | $2,187.76 | $3,388.44 |
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 $2,137.96 Median $2,398.83 Typical High $4,677.35 | Professional | None | $2,137.96 | $2,398.83 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $5,888.44 | Facility | None | $1,621.81 | $2,511.89 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,511.89 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $1,819.70 Typical High $3,467.37 | Professional | None | $251.19 | $1,819.70 | $3,467.37 |
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 $1,905.46 Median $2,454.71 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,454.71 | $4,265.80 |
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 $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,047.13 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,548.82 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $309.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,737.80 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,288.25 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $1,148.15 | $1,288.25 | $1,862.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $512.86 Typical High $758.58 | Professional | 80 · Assistant surgeon | $467.74 | $512.86 | $758.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $363.08 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $323.59 | $363.08 | $524.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $363.08 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $363.08 | $524.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $363.08 Typical High $524.81 | Professional | AS · PA/NP assist | $323.59 | $363.08 | $524.81 |
Where South Carolina sits
The same service costs 8.1 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
$2,089
AK $8,913TX $1,096
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.