How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,072 to $16,218Professionalmedian $1,175 · 10th to 90th $178 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 $1,659.59 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,659.59 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,621.81 | $1,659.59 | $1,659.59 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $15,848.93 | Facility | None | $1,202.26 | $4,570.88 | $15,848.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,318.26 | $1,659.59 |
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 $1,000.00 Median $1,148.15 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,148.15 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $2,398.83 | Facility | None | $912.01 | $1,380.38 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,380.38 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,000.00 Typical High $1,862.09 | Professional | None | $151.36 | $1,000.00 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,318.26 | $2,290.87 |
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 $812.83 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,089.30 Typical High $2,884.03 | Professional | 50 · Both sides | $1,621.81 | $2,089.30 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $691.83 Typical High $954.99 | Professional | 51 · Multiple procedures | $537.03 | $691.83 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $275.42 Typical High $380.19 | Professional | 80 · Assistant surgeon | $213.80 | $275.42 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $194.98 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $151.36 | $194.98 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $194.98 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $194.98 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $194.98 Typical High $269.15 | Professional | AS · PA/NP assist | $151.36 | $194.98 | $269.15 |
Where South Carolina sits
The same service costs 7.1 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· 42nd of 51
$1,318
AK $5,370UT $759
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.