How much rates vary
Facilitymedian $1,175 · 10th to 90th $603 to $7,586Professionalmedian $389 · 10th to 90th $229 to $537
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 $389.05 Median $5,888.44 Typical High $21,877.62 | Facility | None | $389.05 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | None | $338.84 | $389.05 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $7,585.78 | Facility | None | $691.83 | $1,288.25 | $7,585.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $562.34 | Professional | None | $295.12 | $407.38 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,698.24 | Facility | None | $602.56 | $1,047.13 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $676.08 | Professional | None | $416.87 | $416.87 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $676.08 Typical High $1,288.25 | Facility | None | $389.05 | $676.08 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $562.34 | Professional | None | $380.19 | $512.86 | $562.34 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $295.12 Typical High $446.68 | Professional | None | $42.66 | $295.12 | $446.68 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $630.96 | Professional | None | $288.40 | $389.05 | $630.96 |
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 $169.82 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $239.88 | $275.42 | $275.42 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $758.58 Typical High $912.01 | Professional | 50 · Both sides | $707.95 | $758.58 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $257.04 Typical High $302.00 | Professional | 51 · Multiple procedures | $239.88 | $257.04 | $302.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $102.33 Typical High $120.23 | Professional | 80 · Assistant surgeon | $95.50 | $102.33 | $120.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $70.79 Typical High $85.11 | Professional | 81 · Minimal assistant surgeon | $66.07 | $70.79 | $85.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $70.79 Typical High $85.11 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $70.79 | $85.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $70.79 Typical High $85.11 | Professional | AS · PA/NP assist | $66.07 | $70.79 | $85.11 |
Where South Carolina sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 36th of 51
$407
AK $1,349UT $234
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.