How much rates vary
Facilitymedian $2,399 · 10th to 90th $813 to $19,055Professionalmedian $708 · 10th to 90th $98 to $1,175
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 $870.96 Median $10,000.00 Typical High $21,877.62 | Facility | None | $870.96 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $870.96 | Professional | None | $758.58 | $870.96 | $870.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $4,265.80 Typical High $19,054.61 | Facility | None | $851.14 | $4,265.80 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,230.27 | Professional | None | $691.83 | $1,000.00 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,380.38 | Professional | None | $933.25 | $1,023.29 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $2,137.96 | Facility | None | $630.96 | $912.01 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,445.44 | Professional | None | $870.96 | $1,071.52 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $954.99 | Professional | None | $79.43 | $562.34 | $954.99 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $21,379.62 | Facility | None | $1,445.44 | $4,265.80 | $21,379.62 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,513.56 | Professional | None | $630.96 | $812.83 | $1,513.56 |
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 $371.54 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $562.34 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $524.81 | $616.60 | $616.60 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,659.59 Typical High $2,187.76 | Professional | 50 · Both sides | $1,445.44 | $1,659.59 | $2,187.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $549.54 Typical High $724.44 | Professional | 51 · Multiple procedures | $489.78 | $549.54 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $218.78 Typical High $288.40 | Professional | 80 · Assistant surgeon | $194.98 | $218.78 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $154.88 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $134.90 | $154.88 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $154.88 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $154.88 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $154.88 Typical High $204.17 | Professional | AS · PA/NP assist | $134.90 | $154.88 | $204.17 |
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
$794
AK $3,162TX $380
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.