How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,514 to $16,596Professionalmedian $1,549 · 10th to 90th $219 to $2,630
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 $1,862.09 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,862.09 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,862.09 | $1,862.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $11,481.54 | Facility | None | $1,778.28 | $2,951.21 | $11,481.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $12,882.50 | Professional | None | $1,380.38 | $1,862.09 | $12,882.50 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,168.69 Typical High $5,888.44 | Facility | None | $602.56 | $4,168.69 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,778.28 | $1,778.28 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $4,365.16 | Facility | None | $1,318.26 | $1,778.28 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,187.76 | Professional | None | $1,862.09 | $2,089.30 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,148.15 Typical High $1,949.84 | Professional | None | $158.49 | $1,148.15 | $1,949.84 |
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 $1,348.96 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,698.24 | $2,818.38 |
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 $794.33 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,202.26 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $239.88 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,288.25 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,071.52 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $1,023.29 | $1,071.52 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $426.58 Typical High $575.44 | Professional | 80 · Assistant surgeon | $407.38 | $426.58 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $295.12 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $288.40 | $295.12 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $295.12 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $295.12 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $295.12 Typical High $407.38 | Professional | AS · PA/NP assist | $288.40 | $295.12 | $407.38 |
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· 40th of 51
$1,660
AK $6,457TX $331
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.