How much rates vary
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 $645.65 Median $870.96 Typical High $1,071.52 | Professional | None | $645.65 | $870.96 | $1,071.52 |
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 $812.83 Median $831.76 Typical High $1,318.26 | Professional | None | $812.83 | $831.76 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $3,311.31 | Facility | None | $758.58 | $1,445.44 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,047.13 | Professional | None | $851.14 | $933.25 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $891.25 | Professional | None | $79.43 | $524.81 | $891.25 |
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 $144.54 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $125.89 |
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 $501.19 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $588.84 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $512.86 Typical High $660.69 | Professional | 51 · Multiple procedures | $426.58 | $512.86 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $208.93 Typical High $263.03 | Professional | 80 · Assistant surgeon | $169.82 | $208.93 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $144.54 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $117.49 | $144.54 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $144.54 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $144.54 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $144.54 Typical High $181.97 | Professional | AS · PA/NP assist | $117.49 | $144.54 | $181.97 |
Where South Carolina sits
The same service costs 8.5 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· 41st of 51
$759
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.