How much rates vary
Facilitymedian $5,754 · 10th to 90th $977 to $33,113Professionalmedian $1,072 · 10th to 90th $151 to $1,698
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 $1,318.26 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,318.26 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,318.26 | $1,318.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $8,128.31 Typical High $36,307.81 | Facility | None | $1,047.13 | $8,128.31 | $36,307.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,584.89 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $7,943.28 | Facility | None | $630.96 | $2,951.21 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,479.11 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,258.93 Typical High $4,168.69 | Facility | None | $794.33 | $1,258.93 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,318.26 | $1,479.11 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $794.33 Typical High $1,412.54 | Professional | None | $120.23 | $794.33 | $1,412.54 |
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 $954.99 Median $1,230.27 Typical High $2,137.96 | Professional | None | $954.99 | $1,230.27 | $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 $575.44 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $575.44 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $229.09 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $169.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $114.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $933.25 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,511.89 Typical High $3,090.30 | Professional | 50 · Both sides | $2,187.76 | $2,511.89 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $831.76 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $741.31 | $831.76 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $331.13 Typical High $416.87 | Professional | 80 · Assistant surgeon | $295.12 | $331.13 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $234.42 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $204.17 | $234.42 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $234.42 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $234.42 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $234.42 Typical High $288.40 | Professional | AS · PA/NP assist | $204.17 | $234.42 | $288.40 |
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· 45th of 51
$1,175
AK $4,786TX $575
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.