How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,479 · 10th to 90th $214 to $2,512
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 $1,819.70 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,819.70 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,819.70 | $1,819.70 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,445.44 | $1,862.09 |
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 $1,659.59 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,659.59 | $1,778.28 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $4,265.80 | Facility | None | $1,258.93 | $1,819.70 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,995.26 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,348.96 Typical High $2,511.89 | Professional | None | $199.53 | $1,348.96 | $2,511.89 |
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 $1,445.44 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,778.28 | $3,090.30 |
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 $758.58 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $758.58 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,148.15 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $151.36 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,258.93 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $1,000.00 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $912.01 | $1,000.00 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $398.11 Typical High $549.54 | Professional | 80 · Assistant surgeon | $363.08 | $398.11 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $281.84 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $251.19 | $281.84 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $281.84 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $281.84 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $281.84 Typical High $389.05 | Professional | AS · PA/NP assist | $251.19 | $281.84 | $389.05 |
Where South Carolina sits
The same service costs 7.2 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· 46th of 51
$1,479
AK $6,457TX $891
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.