How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,514 to $17,783Professionalmedian $851 · 10th to 90th $102 to $1,230
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 $1,047.13 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,047.13 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $891.25 | $1,047.13 | $1,047.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $5,754.40 Typical High $17,378.01 | Facility | None | $1,905.46 | $5,754.40 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,348.96 | Professional | None | $794.33 | $1,071.52 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,311.31 Typical High $4,677.35 | Facility | None | $602.56 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,023.29 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $2,511.89 Typical High $3,162.28 | Facility | None | $933.25 | $2,511.89 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,174.90 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $676.08 Typical High $1,122.02 | Professional | None | $79.43 | $676.08 | $1,122.02 |
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 $758.58 Median $954.99 Typical High $1,548.82 | Professional | None | $758.58 | $954.99 | $1,548.82 |
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 $446.68 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $630.96 Typical High $812.83 | Professional | 51 · Multiple procedures | $537.03 | $630.96 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $251.19 Typical High $323.59 | Professional | 80 · Assistant surgeon | $218.78 | $251.19 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $177.83 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $151.36 | $177.83 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $177.83 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $177.83 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $229.09 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $229.09 |
Where South Carolina sits
The same service costs 20.0 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· 39th of 51
$955
AK $3,715TX $186
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.