How much rates vary
Facilitymedian $1,072 · 10th to 90th $437 to $8,511Professionalmedian $1,445 · 10th to 90th $229 to $2,138
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 $1,659.59 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,659.59 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,659.59 | $1,659.59 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,445.44 | $1,949.84 |
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 $1,445.44 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,445.44 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $3,890.45 | Facility | None | $1,071.52 | $1,659.59 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,621.81 | $1,737.80 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,348.96 Typical High $2,089.30 | Professional | None | $190.55 | $1,348.96 | $2,089.30 |
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 $1,148.15 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,445.44 | $2,344.23 |
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 $691.83 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $954.99 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $812.83 | $954.99 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $380.19 Typical High $501.19 | Professional | 80 · Assistant surgeon | $323.59 | $380.19 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $269.15 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $229.09 | $269.15 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $269.15 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $269.15 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $354.81 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $354.81 |
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· 43rd of 51
$1,445
AK $5,888TX $1,000
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.