How much rates vary
Facilitymedian $16,596 · 10th to 90th $676 to $74,131Professionalmedian $447 · 10th to 90th $288 to $631
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 $446.68 Median $5,888.44 Typical High $21,877.62 | Facility | None | $446.68 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | None | $371.54 | $446.68 | $446.68 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $14,791.08 Typical High $77,624.71 | Facility | None | $691.83 | $14,791.08 | $77,624.71 |
BCBS South Carolina Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $691.83 | Professional | None | $354.81 | $524.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $16,982.44 Typical High $27,542.29 | Facility | None | $602.56 | $16,982.44 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $691.83 | Professional | None | $489.78 | $616.60 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $676.08 Typical High $16,595.87 | Facility | None | $436.52 | $676.08 | $16,595.87 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $676.08 | Professional | None | $436.52 | $501.19 | $676.08 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $363.08 Typical High $537.03 | Professional | None | $42.66 | $363.08 | $537.03 |
United Setting Facility Modifier None Typical Low $5,623.41 Median $21,379.62 Typical High $43,651.58 | Facility | None | $5,623.41 | $21,379.62 | $43,651.58 |
United Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $812.83 | Professional | None | $316.23 | $416.87 | $812.83 |
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 $186.21 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $56.23 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $37.15 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $263.03 | $316.23 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $275.42 Typical High $363.08 | Professional | 51 · Multiple procedures | $245.47 | $275.42 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $109.65 Typical High $144.54 | Professional | 80 · Assistant surgeon | $97.72 | $109.65 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $77.62 Typical High $100.00 | Professional | 81 · Minimal assistant surgeon | $69.18 | $77.62 | $100.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $77.62 Typical High $100.00 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $77.62 | $100.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $77.62 Typical High $100.00 | Professional | AS · PA/NP assist | $69.18 | $77.62 | $100.00 |
Where South Carolina sits
The same service costs 29.4 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $37,066MT $1,262
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.