How much rates vary
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 $1,000.00 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,000.00 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | None | $870.96 | $1,000.00 | $1,000.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $4,073.80 Typical High $11,481.54 | Facility | None | $851.14 | $4,073.80 | $11,481.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,071.52 | Professional | None | $812.83 | $851.14 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $7,244.36 | Facility | None | $602.56 | $2,398.83 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,548.82 | Professional | None | $933.25 | $977.24 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $2,398.83 | Facility | None | $630.96 | $1,000.00 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,318.26 | Professional | None | $977.24 | $1,148.15 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $660.69 Typical High $1,122.02 | Professional | None | $79.43 | $660.69 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,445.44 | Professional | None | $691.83 | $891.25 | $1,445.44 |
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 $436.52 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $645.65 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $602.56 | $707.95 | $707.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,905.46 Typical High $2,344.23 | Professional | 50 · Both sides | $1,479.11 | $1,905.46 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $630.96 Typical High $776.25 | Professional | 51 · Multiple procedures | $489.78 | $630.96 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $251.19 Typical High $309.03 | Professional | 80 · Assistant surgeon | $194.98 | $251.19 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $177.83 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $138.04 | $177.83 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $177.83 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $177.83 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $177.83 Typical High $218.78 | Professional | AS · PA/NP assist | $138.04 | $177.83 | $218.78 |
Where South Carolina sits
The same service costs 8.1 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
$851
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.