How much rates vary
Facilitymedian $2,455 · 10th to 90th $977 to $19,055Professionalmedian $871 · 10th to 90th $102 to $1,380
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 $1,096.48 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,096.48 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,096.48 | Professional | None | $933.25 | $1,096.48 | $1,096.48 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $5,370.32 Typical High $19,054.61 | Facility | None | $1,047.13 | $5,370.32 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $1,659.59 | Professional | None | $851.14 | $1,348.96 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $2,818.38 | Facility | None | $630.96 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,258.93 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,096.48 Typical High $2,454.71 | Facility | None | $794.33 | $1,096.48 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,412.54 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $676.08 Typical High $1,148.15 | Professional | None | $79.43 | $676.08 | $1,148.15 |
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 $776.25 Median $1,000.00 Typical High $1,778.28 | Professional | None | $776.25 | $1,000.00 | $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 $467.74 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $467.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $186.21 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $758.58 | $758.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,454.71 Typical High $2,570.40 | Professional | 50 · Both sides | $1,698.24 | $2,454.71 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $831.76 Typical High $870.96 | Professional | 51 · Multiple procedures | $575.44 | $831.76 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $331.13 Typical High $346.74 | Professional | 80 · Assistant surgeon | $229.09 | $331.13 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $229.09 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $158.49 | $229.09 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $229.09 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $229.09 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $229.09 Typical High $239.88 | Professional | AS · PA/NP assist | $158.49 | $229.09 | $239.88 |
Where South Carolina sits
The same service costs 16.2 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
$977
AK $3,890TX $240
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.