How much rates vary
Facilitymedian $1,259 · 10th to 90th $661 to $8,913Professionalmedian $490 · 10th to 90th $83 to $692
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 $537.03 Median $5,888.44 Typical High $21,877.62 | Facility | None | $537.03 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | None | $446.68 | $537.03 | $537.03 |
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 $407.38 Median $489.78 Typical High $660.69 | Professional | None | $407.38 | $489.78 | $660.69 |
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 $524.81 Median $524.81 Typical High $831.76 | Professional | None | $524.81 | $524.81 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $676.08 Typical High $1,288.25 | Facility | None | $524.81 | $676.08 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $616.60 | Professional | None | $524.81 | $575.44 | $616.60 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $416.87 Typical High $645.65 | Professional | None | $72.44 | $416.87 | $645.65 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $794.33 | Professional | None | $389.05 | $489.78 | $794.33 |
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 $223.87 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $316.23 | $380.19 | $380.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $870.96 Typical High $1,230.27 | Professional | 50 · Both sides | $831.76 | $870.96 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $288.40 Typical High $407.38 | Professional | 51 · Multiple procedures | $275.42 | $288.40 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $117.49 Typical High $162.18 | Professional | 80 · Assistant surgeon | $112.20 | $117.49 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $77.62 Median $81.28 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $77.62 | $81.28 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $77.62 Median $81.28 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $77.62 | $81.28 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $81.28 Typical High $114.82 | Professional | AS · PA/NP assist | $77.62 | $81.28 | $114.82 |
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· 35th of 51
$525
AK $1,862UT $324
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.