How much rates vary
Facilitymedian $977 · 10th to 90th $437 to $8,511Professionalmedian $1,023 · 10th to 90th $170 to $1,549
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 $1,258.93 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,258.93 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,258.93 | $1,258.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,023.29 | $1,513.56 |
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 $954.99 Median $977.24 Typical High $1,819.70 | Professional | None | $954.99 | $977.24 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,258.93 Typical High $3,019.95 | Facility | None | $724.44 | $1,258.93 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,230.27 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $912.01 Typical High $1,513.56 | Professional | None | $154.88 | $912.01 | $1,513.56 |
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 $851.14 Median $1,047.13 Typical High $1,698.24 | Professional | None | $851.14 | $1,047.13 | $1,698.24 |
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 $524.81 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $104.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $891.25 | $891.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,041.74 Typical High $2,884.03 | Professional | 50 · Both sides | $1,479.11 | $2,041.74 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $691.83 Typical High $954.99 | Professional | 51 · Multiple procedures | $501.19 | $691.83 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $275.42 Typical High $380.19 | Professional | 80 · Assistant surgeon | $199.53 | $275.42 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $190.55 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $138.04 | $190.55 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $190.55 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $190.55 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $190.55 Typical High $269.15 | Professional | AS · PA/NP assist | $138.04 | $190.55 | $269.15 |
Where South Carolina sits
The same service costs 21.9 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· 44th of 51
$1,023
AK $4,467TX $204
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.