How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,122 to $17,783Professionalmedian $1,445 · 10th to 90th $200 to $2,291
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 $1,905.46 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,905.46 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,905.46 | $1,905.46 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $5,754.40 Typical High $17,378.01 | Facility | None | $1,202.26 | $5,754.40 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,995.26 | $2,691.53 |
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 $1,905.46 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,905.46 | $2,041.74 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,737.80 Median $3,162.28 Typical High $3,890.45 | Facility | None | $1,737.80 | $3,162.28 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,862.09 | $1,995.26 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,122.02 Typical High $1,905.46 | Professional | None | $162.18 | $1,122.02 | $1,905.46 |
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 $812.83 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $812.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,202.26 | $1,412.54 | $1,412.54 |
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 $162.18 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $162.18 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,318.26 | $1,318.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,148.15 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $933.25 | $1,148.15 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $457.09 Typical High $588.84 | Professional | 80 · Assistant surgeon | $371.54 | $457.09 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $323.59 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $263.03 | $323.59 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $323.59 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $323.59 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $323.59 Typical High $407.38 | Professional | AS · PA/NP assist | $263.03 | $323.59 | $407.38 |
Where South Carolina sits
The same service costs 20.4 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· 45th of 51
$1,585
AK $6,607TX $324
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.