How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,514 to $16,596Professionalmedian $2,455 · 10th to 90th $389 to $4,169
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 $3,235.94 Median $10,964.78 Typical High $21,877.62 | Facility | None | $3,235.94 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,754.23 | $3,235.94 | $3,235.94 |
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 $2,290.87 Median $3,630.78 Typical High $5,011.87 | Professional | None | $2,290.87 | $3,630.78 | $5,011.87 |
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 $3,311.31 Median $3,467.37 Typical High $5,248.07 | Professional | None | $3,311.31 | $3,467.37 | $5,248.07 |
Medcost Setting Facility Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $8,511.38 | Facility | None | $2,630.27 | $3,235.94 | $8,511.38 |
Medcost Setting Professional Modifier None Typical Low $3,235.94 Median $3,467.37 Typical High $4,168.69 | Professional | None | $3,235.94 | $3,467.37 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $1,862.09 Typical High $3,235.94 | Professional | None | $323.59 | $1,862.09 | $3,235.94 |
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 $2,344.23 Median $2,884.03 Typical High $4,897.79 | Professional | None | $2,344.23 | $2,884.03 | $4,897.79 |
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 $1,380.38 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,380.38 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $549.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,089.30 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $416.87 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,238.72 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,737.80 Median $2,041.74 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $1,737.80 | $2,041.74 | $2,511.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $812.83 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $691.83 | $812.83 | $1,000.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $478.63 Median $562.34 Typical High $707.95 | Professional | 81 · Minimal assistant surgeon | $478.63 | $562.34 | $707.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $478.63 Median $562.34 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $478.63 | $562.34 | $707.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $478.63 Median $562.34 Typical High $707.95 | Professional | AS · PA/NP assist | $478.63 | $562.34 | $707.95 |
Where South Carolina sits
The same service costs 20.9 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· 46th of 51
$2,570
AK $11,220TX $537
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.