How much rates vary
Facilitymedian $2,455 · 10th to 90th $692 to $19,953Professionalmedian $1,778 · 10th to 90th $309 to $3,020
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 $2,187.76 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,187.76 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,949.84 | $2,187.76 | $2,187.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Facility | None | $8,709.64 | $8,709.64 | $8,709.64 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $4,265.80 | Professional | None | $1,698.24 | $2,630.27 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,344.23 | $4,466.84 |
Medcost Setting Facility Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $5,495.41 | Facility | None | $1,819.70 | $2,187.76 | $5,495.41 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $2,818.38 | Professional | None | $2,089.30 | $2,511.89 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $1,479.11 Typical High $2,818.38 | Professional | None | $275.42 | $1,479.11 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $21,379.62 | Facility | None | $1,445.44 | $3,715.35 | $21,379.62 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $4,168.69 | Professional | None | $1,905.46 | $2,344.23 | $4,168.69 |
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 $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $977.24 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,479.11 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $295.12 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,548.82 | $1,548.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $3,715.35 Typical High $5,370.32 | Professional | 50 · Both sides | $3,162.28 | $3,715.35 | $5,370.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,230.27 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $1,047.13 | $1,230.27 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $501.19 Typical High $707.95 | Professional | 80 · Assistant surgeon | $416.87 | $501.19 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $346.74 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $295.12 | $346.74 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $346.74 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $346.74 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $346.74 Typical High $501.19 | Professional | AS · PA/NP assist | $295.12 | $346.74 | $501.19 |
Where South Carolina sits
The same service costs 8.5 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· 46th of 51
$1,778
AK $8,128TX $955
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.