How much rates vary
Facilitymedian $1,778 · 10th to 90th $794 to $9,333Professionalmedian $776 · 10th to 90th $89 to $1,072
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 $851.14 Median $10,000.00 Typical High $21,877.62 | Facility | None | $851.14 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $851.14 | Professional | None | $707.95 | $851.14 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,174.90 | Professional | None | $707.95 | $707.95 | $1,174.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,949.84 Typical High $7,585.78 | Facility | None | $851.14 | $1,949.84 | $7,585.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,047.13 | Professional | None | $645.65 | $794.33 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,698.24 | Facility | None | $602.56 | $1,071.52 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,318.26 | Professional | None | $794.33 | $794.33 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $831.76 Typical High $1,698.24 | Facility | None | $616.60 | $831.76 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $977.24 | Professional | None | $741.31 | $870.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $660.69 Typical High $1,000.00 | Professional | None | $75.86 | $660.69 | $1,000.00 |
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 $602.56 Median $758.58 Typical High $1,230.27 | Professional | None | $602.56 | $758.58 | $1,230.27 |
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 $354.81 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $602.56 | $602.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $489.78 Typical High $645.65 | Professional | 51 · Multiple procedures | $371.54 | $489.78 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $194.98 Typical High $257.04 | Professional | 80 · Assistant surgeon | $147.91 | $194.98 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $134.90 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $104.71 | $134.90 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $134.90 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $134.90 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $134.90 Typical High $181.97 | Professional | AS · PA/NP assist | $104.71 | $134.90 | $181.97 |
Where South Carolina sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.