How much rates vary
Facilitymedian $1,905 · 10th to 90th $832 to $9,120Professionalmedian $2,570 · 10th to 90th $398 to $3,467
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 $2,951.21 Median $10,964.78 Typical High $21,877.62 | Facility | None | $2,951.21 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,630.27 | $2,951.21 | $2,951.21 |
Ambetter Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $2,951.21 Typical High $9,332.54 | Facility | None | $1,023.29 | $2,951.21 | $9,332.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $4,365.16 | Professional | None | $2,290.87 | $2,884.03 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,041.74 | Facility | None | $630.96 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,290.87 | $2,818.38 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,235.94 | Facility | None | $933.25 | $1,445.44 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $3,090.30 Typical High $3,235.94 | Professional | None | $2,570.40 | $3,090.30 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $1,819.70 Typical High $2,884.03 | Professional | None | $275.42 | $1,819.70 | $2,884.03 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $4,570.88 | Professional | None | $2,089.30 | $2,630.27 | $4,570.88 |
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 $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,318.26 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,995.26 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,041.74 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,288.25 Median $1,548.82 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $1,288.25 | $1,548.82 | $1,905.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $616.60 Typical High $776.25 | Professional | 80 · Assistant surgeon | $512.86 | $616.60 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $436.52 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $363.08 | $436.52 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $436.52 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $436.52 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $436.52 Typical High $537.03 | Professional | AS · PA/NP assist | $363.08 | $436.52 | $537.03 |
Where South Carolina sits
The same service costs 15.8 times more in Alaska than in Texas. 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· 41st of 51
$2,455
AK $8,128TX $513
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.