How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,660 to $23,442Professionalmedian $1,230 · 10th to 90th $851 to $1,905
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 $1,230.27 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,230.27 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,230.27 | $1,230.27 |
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 $1,949.84 Median $1,949.84 Typical High $1,995.26 | Professional | None | $1,949.84 | $1,949.84 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,232.93 Typical High $14,454.40 | Facility | None | $602.56 | $10,232.93 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,202.26 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,380.38 Typical High $21,379.62 | Facility | None | $977.24 | $1,380.38 | $21,379.62 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,318.26 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $630.96 | Professional | None | $501.19 | $630.96 | $630.96 |
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 $870.96 Median $1,122.02 Typical High $2,691.53 | Professional | None | $870.96 | $1,122.02 | $2,691.53 |
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 $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $524.81 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $794.33 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $741.31 | $870.96 | $870.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,187.76 Typical High $2,884.03 | Professional | 50 · Both sides | $1,862.09 | $2,187.76 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $724.44 Typical High $954.99 | Professional | 51 · Multiple procedures | $630.96 | $724.44 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $295.12 Typical High $389.05 | Professional | 80 · Assistant surgeon | $251.19 | $295.12 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $204.17 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $173.78 | $204.17 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $204.17 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $204.17 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $269.15 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $269.15 |
Where South Carolina sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 37th of 51
$1,380
AK $4,467HI $95.50
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.