How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,514 to $17,783Professionalmedian $3,311 · 10th to 90th $525 to $5,012
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 $4,365.16 Median $10,964.78 Typical High $21,877.62 | Facility | None | $4,365.16 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,715.35 | $4,365.16 | $4,365.16 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $14,125.38 | Facility | None | $1,778.28 | $2,951.21 | $14,125.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $4,677.35 | Professional | None | $3,311.31 | $4,677.35 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,011.87 Typical High $7,244.36 | Facility | None | $602.56 | $5,011.87 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $6,606.93 | Professional | None | $4,168.69 | $4,570.88 | $6,606.93 |
Medcost Setting Facility Modifier None Typical Low $3,467.37 Median $4,365.16 Typical High $10,471.29 | Facility | None | $3,467.37 | $4,365.16 | $10,471.29 |
Medcost Setting Professional Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $5,495.41 | Professional | None | $4,168.69 | $4,365.16 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $436.52 Median $2,630.27 Typical High $4,570.88 | Professional | None | $436.52 | $2,630.27 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $6,456.54 | Professional | None | $3,162.28 | $3,890.45 | $6,456.54 |
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 $1,862.09 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,862.09 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $741.31 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,818.38 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 55 · Aftercare only | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $371.54 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $3,019.95 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,630.27 | $3,019.95 | $3,019.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $6,309.57 Median $8,128.31 Typical High $10,000.00 | Professional | 50 · Both sides | $6,309.57 | $8,128.31 | $10,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,089.30 Median $2,691.53 Typical High $3,388.44 | Professional | 51 · Multiple procedures | $2,089.30 | $2,691.53 | $3,388.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $831.76 Median $1,096.48 Typical High $1,348.96 | Professional | 80 · Assistant surgeon | $831.76 | $1,096.48 | $1,348.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $588.84 Median $758.58 Typical High $954.99 | Professional | 81 · Minimal assistant surgeon | $588.84 | $758.58 | $954.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $588.84 Median $758.58 Typical High $954.99 | Professional | 82 · Assistant surgeon, no resident | $588.84 | $758.58 | $954.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $588.84 Median $758.58 Typical High $954.99 | Professional | AS · PA/NP assist | $588.84 | $758.58 | $954.99 |
Where South Carolina sits
The same service costs 20.4 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· 46th of 51
$3,311
AK $15,488TX $759
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.