How much rates vary
Facilitymedian $891 · 10th to 90th $513 to $7,079Professionalmedian $741 · 10th to 90th $115 to $1,148
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 $1,023.29 Median $5,623.41 Typical High $21,877.62 | Facility | None | $1,023.29 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,047.13 | Professional | None | $776.25 | $1,023.29 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $758.58 | Professional | None | $691.83 | $691.83 | $758.58 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $2,344.23 | Facility | None | $512.86 | $794.33 | $2,344.23 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Professional | None | $691.83 | $851.14 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,398.83 Typical High $3,388.44 | Facility | None | $457.09 | $2,398.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,445.44 | Professional | None | $616.60 | $691.83 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $660.69 Typical High $2,754.23 | Facility | None | $436.52 | $660.69 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $977.24 | Professional | None | $707.95 | $851.14 | $977.24 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $602.56 Typical High $1,174.90 | Professional | None | $97.72 | $602.56 | $1,174.90 |
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 $645.65 Median $794.33 Typical High $1,412.54 | Professional | None | $645.65 | $794.33 | $1,412.54 |
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 $489.78 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $489.78 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $741.31 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $691.83 | $724.44 | $724.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,288.25 Typical High $1,737.80 | Professional | 50 · Both sides | $1,047.13 | $1,288.25 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $346.74 Median $426.58 Typical High $575.44 | Professional | 51 · Multiple procedures | $346.74 | $426.58 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $169.82 Typical High $234.42 | Professional | 80 · Assistant surgeon | $141.25 | $169.82 | $234.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $97.72 Median $120.23 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $97.72 | $120.23 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $97.72 Median $120.23 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $97.72 | $120.23 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $120.23 Typical High $162.18 | Professional | AS · PA/NP assist | $97.72 | $120.23 | $162.18 |
Where South Carolina sits
The same service costs 5.4 times more in Alaska than in South Carolina. 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 $8,807SC $1,633
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.