How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,148 to $19,498Professionalmedian $933 · 10th to 90th $115 to $1,380
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 $1,148.15 Median $5,888.44 Typical High $21,877.62 | Facility | None | $1,148.15 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,000.00 | $1,148.15 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
BCBS South Carolina Setting Facility Modifier None Typical Low $6,606.93 Median $11,481.54 Typical High $19,952.62 | Facility | None | $6,606.93 | $11,481.54 | $19,952.62 |
BCBS South Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,202.26 | Professional | None | $851.14 | $1,122.02 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,235.94 Typical High $4,677.35 | Facility | None | $602.56 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,258.93 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $2,691.53 Typical High $3,162.28 | Facility | None | $1,148.15 | $2,691.53 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,380.38 | $1,513.56 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $707.95 Typical High $1,202.26 | Professional | None | $79.43 | $707.95 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,819.70 | Professional | None | $870.96 | $1,148.15 | $1,819.70 |
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 $489.78 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $489.78 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $741.31 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $691.83 | $794.33 | $794.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $724.44 Typical High $891.25 | Professional | 51 · Multiple procedures | $676.08 | $724.44 | $891.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $295.12 Typical High $354.81 | Professional | 80 · Assistant surgeon | $269.15 | $295.12 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $204.17 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $186.21 | $204.17 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $204.17 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $204.17 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $204.17 Typical High $245.47 | Professional | AS · PA/NP assist | $186.21 | $204.17 | $245.47 |
Where South Carolina sits
The same service costs 18.2 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
$1,000
AK $3,981TX $219
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.