How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,230 to $11,220Professionalmedian $692 · 10th to 90th $98 to $1,000
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 $851.14 Median $12,022.64 Typical High $21,877.62 | Facility | None | $851.14 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | None | $724.44 | $851.14 | $851.14 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,659.59 Median $3,630.78 Typical High $10,232.93 | Facility | None | $1,659.59 | $3,630.78 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $954.99 | Professional | None | $660.69 | $758.58 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $4,677.35 | Facility | None | $630.96 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,318.26 | Professional | None | $776.25 | $812.83 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,258.93 Typical High $3,311.31 | Facility | None | $794.33 | $1,258.93 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,000.00 | Professional | None | $831.76 | $870.96 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $954.99 | Professional | None | $79.43 | $562.34 | $954.99 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,258.93 | Professional | None | $616.60 | $776.25 | $1,258.93 |
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 $363.08 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $363.08 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $602.56 | $602.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $457.09 Typical High $660.69 | Professional | 51 · Multiple procedures | $416.87 | $457.09 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $181.97 Typical High $263.03 | Professional | 80 · Assistant surgeon | $165.96 | $181.97 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $125.89 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $114.82 | $125.89 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $125.89 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $125.89 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $125.89 Typical High $186.21 | Professional | AS · PA/NP assist | $114.82 | $125.89 | $186.21 |
Where South Carolina sits
The same service costs 17.4 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· 43rd of 51
$759
AK $3,020TX $174
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.