How much rates vary
Facilitymedian $3,631 · 10th to 90th $676 to $16,218Professionalmedian $1,096 · 10th to 90th $132 to $1,514
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 $1,230.27 Median $5,888.44 Typical High $21,877.62 | Facility | None | $1,230.27 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,230.27 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $3,890.45 Typical High $15,135.61 | Facility | None | $691.83 | $3,890.45 | $15,135.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,584.89 | Professional | None | $912.01 | $1,202.26 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $10,232.93 | Facility | None | $602.56 | $1,995.26 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,174.90 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $870.96 Typical High $2,884.03 | Facility | None | $588.84 | $870.96 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,258.93 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $912.01 Typical High $1,380.38 | Professional | None | $117.49 | $912.01 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,778.28 | Professional | None | $870.96 | $1,096.48 | $1,778.28 |
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 $512.86 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $776.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $102.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $691.83 Typical High $933.25 | Professional | 51 · Multiple procedures | $549.54 | $691.83 | $933.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $275.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $218.78 | $275.42 | $371.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $194.98 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $154.88 | $194.98 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $194.98 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $194.98 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $194.98 Typical High $263.03 | Professional | AS · PA/NP assist | $154.88 | $194.98 | $263.03 |
Where South Carolina sits
The same service costs 6.2 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· 39th of 51
$1,122
AK $4,266UT $692
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.