How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,698 to $23,442Professionalmedian $1,023 · 10th to 90th $151 to $1,514
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 $1,288.25 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,288.25 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,288.25 | $1,288.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,467.37 Median $6,918.31 Typical High $28,183.83 | Facility | None | $3,467.37 | $6,918.31 | $28,183.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $1,778.28 | Professional | None | $977.24 | $1,412.54 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,413.10 Typical High $10,471.29 | Facility | None | $602.56 | $7,413.10 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,230.27 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,288.25 Typical High $15,135.61 | Facility | None | $912.01 | $1,288.25 | $15,135.61 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,479.11 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $794.33 Typical High $1,380.38 | Professional | None | $120.23 | $794.33 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,905.46 | Professional | None | $912.01 | $1,174.90 | $1,905.46 |
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 $549.54 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $549.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $218.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $831.76 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $776.25 | $891.25 | $891.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,238.72 Typical High $2,951.21 | Professional | 50 · Both sides | $1,949.84 | $2,238.72 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $741.31 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $660.69 | $741.31 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $295.12 Typical High $398.11 | Professional | 80 · Assistant surgeon | $263.03 | $295.12 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $208.93 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $181.97 | $208.93 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $208.93 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $208.93 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $208.93 Typical High $275.42 | Professional | AS · PA/NP assist | $181.97 | $208.93 | $275.42 |
Where South Carolina sits
The same service costs 8.3 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· 44th of 51
$1,122
AK $4,571TX $550
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.