How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,479 to $17,783Professionalmedian $1,479 · 10th to 90th $209 to $2,138
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 $1,819.70 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,819.70 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,819.70 | $1,819.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $5,754.40 Typical High $17,378.01 | Facility | None | $1,698.24 | $5,754.40 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,677.35 Typical High $7,762.47 | Facility | None | $630.96 | $4,677.35 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,819.70 | $1,819.70 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,365.16 | Facility | None | $1,202.26 | $1,862.09 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,819.70 | $1,905.46 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,174.90 Typical High $1,949.84 | Professional | None | $162.18 | $1,174.90 | $1,949.84 |
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 $1,318.26 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,698.24 | $2,754.23 |
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 $776.25 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $776.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $316.23 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,174.90 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $234.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,288.25 | $1,288.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $3,162.28 Typical High $4,365.16 | Professional | 50 · Both sides | $2,818.38 | $3,162.28 | $4,365.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,047.13 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $933.25 | $1,047.13 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $416.87 Typical High $588.84 | Professional | 80 · Assistant surgeon | $371.54 | $416.87 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $295.12 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $263.03 | $295.12 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $295.12 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $295.12 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $295.12 Typical High $407.38 | Professional | AS · PA/NP assist | $263.03 | $295.12 | $407.38 |
Where South Carolina sits
The same service costs 20.0 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
$1,622
AK $6,457TX $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.