How much rates vary
Facilitymedian $1,905 · 10th to 90th $631 to $10,471Professionalmedian $575 · 10th to 90th $107 to $871
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 $776.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $776.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $776.25 Typical High $776.25 | Professional | None | $478.63 | $776.25 | $776.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $3,467.37 Typical High $10,964.78 | Facility | None | $1,047.13 | $3,467.37 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $870.96 | Professional | None | $512.86 | $575.44 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $1,949.84 | Facility | None | $630.96 | $1,230.27 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $1,122.02 | Professional | None | $416.87 | $512.86 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $912.01 Typical High $1,698.24 | Facility | None | $691.83 | $912.01 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $436.52 Typical High $851.14 | Professional | None | $91.20 | $436.52 | $851.14 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,606.93 | Facility | None | $302.00 | $1,122.02 | $6,606.93 |
United Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,202.26 | Professional | None | $512.86 | $645.65 | $1,202.26 |
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 $380.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $380.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $575.44 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $75.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $537.03 | $549.54 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,096.48 Typical High $1,318.26 | Professional | 50 · Both sides | $1,071.52 | $1,096.48 | $1,318.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $363.08 Typical High $446.68 | Professional | 51 · Multiple procedures | $354.81 | $363.08 | $446.68 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $147.91 Typical High $177.83 | Professional | 80 · Assistant surgeon | $141.25 | $147.91 | $177.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $102.33 Typical High $123.03 | Professional | 81 · Minimal assistant surgeon | $100.00 | $102.33 | $123.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $102.33 Typical High $123.03 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $102.33 | $123.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $102.33 Typical High $123.03 | Professional | AS · PA/NP assist | $100.00 | $102.33 | $123.03 |
Where South Carolina sits
The same service costs 7.6 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· 45th of 51
$575
AK $2,512UT $331
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.