How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,514 to $17,378Professionalmedian $1,122 · 10th to 90th $158 to $1,820
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 $1,412.54 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,412.54 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,412.54 | $1,412.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,862.09 Median $3,715.35 Typical High $16,595.87 | Facility | None | $1,862.09 | $3,715.35 | $16,595.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,513.56 | $2,187.76 |
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 $1,348.96 Median $1,348.96 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,348.96 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $5,248.07 | Facility | None | $1,023.29 | $1,412.54 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,659.59 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $870.96 Typical High $1,479.11 | Professional | None | $120.23 | $870.96 | $1,479.11 |
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 $1,023.29 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,258.93 | $2,089.30 |
12 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 $602.56 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $239.88 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,000.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,630.27 Typical High $3,311.31 | Professional | 50 · Both sides | $2,187.76 | $2,630.27 | $3,311.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $891.25 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $724.44 | $891.25 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $354.81 Typical High $436.52 | Professional | 80 · Assistant surgeon | $288.40 | $354.81 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $245.47 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $204.17 | $245.47 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $245.47 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $245.47 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $245.47 Typical High $309.03 | Professional | AS · PA/NP assist | $204.17 | $245.47 | $309.03 |
Where South Carolina sits
The same service costs 16.2 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· 42nd of 51
$1,259
AK $5,012TX $309
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.