How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,479 to $17,783Professionalmedian $1,230 · 10th to 90th $209 to $1,862
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 $1,548.82 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,548.82 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,348.96 | $1,548.82 | $1,548.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,698.24 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,445.44 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,311.31 Typical High $4,677.35 | Facility | None | $602.56 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,445.44 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $3,162.28 Typical High $3,715.35 | Facility | None | $1,412.54 | $3,162.28 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,548.82 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $977.24 Typical High $1,659.59 | Professional | None | $162.18 | $977.24 | $1,659.59 |
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 $1,122.02 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,412.54 | $2,290.87 |
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 $676.08 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $676.08 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,000.00 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $933.25 | $1,096.48 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $977.24 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $758.58 | $977.24 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $389.05 Typical High $478.63 | Professional | 80 · Assistant surgeon | $302.00 | $389.05 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $275.42 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $208.93 | $275.42 | $338.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $275.42 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $275.42 | $338.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $275.42 Typical High $338.84 | Professional | AS · PA/NP assist | $208.93 | $275.42 | $338.84 |
Where South Carolina sits
The same service costs 17.0 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
$1,380
AK $5,495TX $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.