How much rates vary
Facilitymedian $6,918 · 10th to 90th $3,020 to $31,623Professionalmedian $2,884 · 10th to 90th $457 to $5,012
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 $3,715.35 Median $9,120.11 Typical High $22,908.68 | Facility | None | $3,715.35 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,715.35 | $3,715.35 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,467.37 Median $6,918.31 Typical High $36,307.81 | Facility | None | $3,467.37 | $6,918.31 | $36,307.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,754.23 Median $4,897.79 Typical High $6,025.60 | Professional | None | $2,754.23 | $4,897.79 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $15,135.61 Typical High $21,379.62 | Facility | None | $602.56 | $15,135.61 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,754.40 | Professional | None | $3,715.35 | $3,715.35 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $3,090.30 Median $3,715.35 Typical High $30,902.95 | Facility | None | $3,090.30 | $3,715.35 | $30,902.95 |
Medcost Setting Professional Modifier None Typical Low $3,715.35 Median $4,570.88 Typical High $6,918.31 | Professional | None | $3,715.35 | $4,570.88 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $2,290.87 Typical High $3,890.45 | Professional | None | $363.08 | $2,290.87 | $3,890.45 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $11,220.18 Typical High $33,884.42 | Facility | None | $3,311.31 | $11,220.18 | $33,884.42 |
United Setting Professional Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $5,623.41 | Professional | None | $2,691.53 | $3,311.31 | $5,623.41 |
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 $1,584.89 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,584.89 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $630.96 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,398.83 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $478.63 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,570.40 | $2,570.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $5,754.40 Median $7,413.10 Typical High $10,232.93 | Professional | 50 · Both sides | $5,754.40 | $7,413.10 | $10,232.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,905.46 Median $2,511.89 Typical High $3,467.37 | Professional | 51 · Multiple procedures | $1,905.46 | $2,511.89 | $3,467.37 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $758.58 Median $1,000.00 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $758.58 | $1,000.00 | $1,380.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $537.03 Median $691.83 Typical High $954.99 | Professional | 81 · Minimal assistant surgeon | $537.03 | $691.83 | $954.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $537.03 Median $691.83 Typical High $954.99 | Professional | 82 · Assistant surgeon, no resident | $537.03 | $691.83 | $954.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $537.03 Median $691.83 Typical High $954.99 | Professional | AS · PA/NP assist | $537.03 | $691.83 | $954.99 |
Where South Carolina sits
The same service costs 20.4 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· 45th of 51
$3,162
AK $13,183TX $646
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.