How much rates vary
Facilitymedian $1,318 · 10th to 90th $676 to $17,378Professionalmedian $1,862 · 10th to 90th $295 to $3,162
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 $2,344.23 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,344.23 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,995.26 | $2,344.23 | $2,344.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $13,182.57 | Facility | None | $676.08 | $870.96 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,778.28 Median $3,090.30 Typical High $3,715.35 | Professional | None | $1,778.28 | $3,090.30 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,995.26 | Facility | None | $602.56 | $1,230.27 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,570.40 | $2,818.38 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $5,623.41 | Facility | None | $2,344.23 | $2,511.89 | $5,623.41 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $4,570.88 | Professional | None | $2,344.23 | $3,019.95 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $1,445.44 Typical High $2,454.71 | Professional | None | $239.88 | $1,445.44 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $4,168.69 | Professional | None | $1,698.24 | $2,238.72 | $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 $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,000.00 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $398.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,513.56 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,659.59 | $1,659.59 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $5,495.41 Typical High $6,760.83 | Professional | 50 · Both sides | $3,981.07 | $5,495.41 | $6,760.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,348.96 Median $1,862.09 Typical High $2,238.72 | Professional | 51 · Multiple procedures | $1,348.96 | $1,862.09 | $2,238.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $741.31 Typical High $912.01 | Professional | 80 · Assistant surgeon | $537.03 | $741.31 | $912.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $512.86 Typical High $630.96 | Professional | 81 · Minimal assistant surgeon | $371.54 | $512.86 | $630.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $512.86 Typical High $630.96 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $512.86 | $630.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $512.86 Typical High $630.96 | Professional | AS · PA/NP assist | $371.54 | $512.86 | $630.96 |
Where South Carolina sits
The same service costs 19.5 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
$1,820
AK $8,318TX $427
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.