How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $8,511Professionalmedian $977 · 10th to 90th $135 to $1,622
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 $1,148.15 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,148.15 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | None | $954.99 | $1,148.15 | $1,148.15 |
BCBS South Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,819.70 | Professional | None | $933.25 | $1,071.52 | $1,819.70 |
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 $1,023.29 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,174.90 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,148.15 Typical High $2,691.53 | Facility | None | $758.58 | $1,148.15 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,202.26 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $851.14 Typical High $1,621.81 | Professional | None | $125.89 | $851.14 | $1,621.81 |
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 $912.01 Median $1,122.02 Typical High $1,949.84 | Professional | None | $912.01 | $1,122.02 | $1,949.84 |
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 $478.63 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $812.83 | $812.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $602.56 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $562.34 | $602.56 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $239.88 Typical High $416.87 | Professional | 80 · Assistant surgeon | $223.87 | $239.88 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $169.82 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $158.49 | $169.82 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $169.82 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $169.82 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $169.82 Typical High $288.40 | Professional | AS · PA/NP assist | $158.49 | $169.82 | $288.40 |
Where South Carolina sits
The same service costs 6.8 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· 45th of 51
$977
AK $4,074TX $603
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.