How much rates vary
Facilitymedian $6,607 · 10th to 90th $955 to $25,119Professionalmedian $1,445 · 10th to 90th $229 to $2,089
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 $1,621.81 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,621.81 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,621.81 | $1,621.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,513.56 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $2,238.72 Typical High $9,549.93 | Facility | None | $102.33 | $2,238.72 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,380.38 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $3,801.89 | Facility | None | $1,071.52 | $1,621.81 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,698.24 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,288.25 Typical High $1,995.26 | Professional | None | $190.55 | $1,288.25 | $1,995.26 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $10,471.29 Typical High $28,840.32 | Facility | None | $3,311.31 | $10,471.29 | $28,840.32 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,380.38 | $2,290.87 |
12 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 $676.08 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,202.26 | $1,202.26 |
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 $134.90 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,122.02 | $1,122.02 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,630.27 Typical High $3,630.78 | Professional | 50 · Both sides | $2,089.30 | $2,630.27 | $3,630.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $870.96 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $707.95 | $870.96 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $354.81 Typical High $489.78 | Professional | 80 · Assistant surgeon | $281.84 | $354.81 | $489.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $245.47 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $194.98 | $245.47 | $338.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $245.47 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $245.47 | $338.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $245.47 Typical High $338.84 | Professional | AS · PA/NP assist | $194.98 | $245.47 | $338.84 |
Where South Carolina sits
The same service costs 5.9 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· 39th of 51
$1,479
AK $5,754TX $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.