How much rates vary
Facilitymedian $5,248 · 10th to 90th $977 to $19,055Professionalmedian $1,000 · 10th to 90th $151 to $1,660
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 $10,000.00 Typical High $21,877.62 | Facility | None | $1,548.82 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,548.82 | $1,548.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $6,025.60 Typical High $19,054.61 | Facility | None | $1,047.13 | $6,025.60 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,348.96 | Professional | None | $870.96 | $933.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $7,585.78 | Facility | None | $602.56 | $2,398.83 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $2,344.23 | Professional | None | $831.76 | $870.96 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $3,311.31 Typical High $3,630.78 | Facility | None | $1,479.11 | $3,311.31 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,412.54 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $933.25 Typical High $1,584.89 | Professional | None | $120.23 | $933.25 | $1,584.89 |
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 $912.01 Median $1,258.93 Typical High $2,137.96 | Professional | None | $912.01 | $1,258.93 | $2,137.96 |
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 $660.69 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $131.83 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $1,071.52 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,137.96 Typical High $3,548.13 | Professional | 50 · Both sides | $1,584.89 | $2,137.96 | $3,548.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $707.95 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $524.81 | $707.95 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $281.84 Typical High $478.63 | Professional | 80 · Assistant surgeon | $208.93 | $281.84 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $199.53 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $147.91 | $199.53 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $199.53 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $199.53 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $199.53 Typical High $331.13 | Professional | AS · PA/NP assist | $147.91 | $199.53 | $331.13 |
Where South Carolina sits
The same service costs 8.9 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· 45th of 51
$1,096
AK $5,495TX $617
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.