How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,096 to $22,387Professionalmedian $1,023 · 10th to 90th $107 to $1,479
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 $1,202.26 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,202.26 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,202.26 | $1,202.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $8,511.38 Typical High $22,908.68 | Facility | None | $1,202.26 | $8,511.38 | $22,908.68 |
BCBS South Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,659.59 | Professional | None | $933.25 | $1,318.26 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,388.44 Typical High $14,791.08 | Facility | None | $630.96 | $3,388.44 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,148.15 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,202.26 Typical High $3,162.28 | Facility | None | $912.01 | $1,202.26 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,412.54 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $758.58 Typical High $1,318.26 | Professional | None | $79.43 | $758.58 | $1,318.26 |
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 $870.96 Median $1,096.48 Typical High $1,778.28 | Professional | None | $870.96 | $1,096.48 | $1,778.28 |
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 $524.81 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $776.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $851.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,290.87 Typical High $2,818.38 | Professional | 50 · Both sides | $1,905.46 | $2,290.87 | $2,818.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $758.58 Typical High $933.25 | Professional | 51 · Multiple procedures | $630.96 | $758.58 | $933.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $302.00 Typical High $380.19 | Professional | 80 · Assistant surgeon | $257.04 | $302.00 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $213.80 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $177.83 | $213.80 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $213.80 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $213.80 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $213.80 Typical High $263.03 | Professional | AS · PA/NP assist | $177.83 | $213.80 | $263.03 |
Where South Carolina sits
The same service costs 7.9 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· 41st of 51
$1,122
AK $4,365TX $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.