How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,122 to $16,982Professionalmedian $1,047 · 10th to 90th $166 to $1,862
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 $1,380.38 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,380.38 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,380.38 | $1,548.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $16,218.10 | Facility | None | $1,230.27 | $5,011.87 | $16,218.10 |
BCBS South Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,659.59 Typical High $1,862.09 | Professional | None | $912.01 | $1,659.59 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $3,388.44 | Facility | None | $630.96 | $2,398.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,995.26 | Professional | None | $954.99 | $1,122.02 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $3,019.95 | Facility | None | $912.01 | $1,380.38 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,258.93 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $776.25 Typical High $1,479.11 | Professional | None | $138.04 | $776.25 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $3,890.45 Typical High $21,379.62 | Facility | None | $1,445.44 | $3,890.45 | $21,379.62 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,344.23 | Professional | None | $954.99 | $1,202.26 | $2,344.23 |
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 $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $977.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,344.23 Typical High $3,630.78 | Professional | 50 · Both sides | $1,584.89 | $2,344.23 | $3,630.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $794.33 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $524.81 | $794.33 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $316.23 Typical High $478.63 | Professional | 80 · Assistant surgeon | $208.93 | $316.23 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $147.91 | $223.87 | $338.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $223.87 | $338.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | AS · PA/NP assist | $147.91 | $223.87 | $338.84 |
Where South Carolina sits
The same service costs 3.1 times more in Alaska than in Montana. 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 $10,355MT $3,360
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.