How much rates vary
Facilitymedian $2,239 · 10th to 90th $851 to $7,244Professionalmedian $1,318 · 10th to 90th $204 to $1,905
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 $1,659.59 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,659.59 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,659.59 | $1,659.59 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $2,344.23 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,344.23 | $6,918.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,584.89 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,096.48 Typical High $1,778.28 | Facility | None | $630.96 | $1,096.48 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,479.11 | $1,513.56 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $2,238.72 | Facility | None | $724.44 | $1,174.90 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,659.59 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,047.13 Typical High $1,778.28 | Professional | None | $162.18 | $1,047.13 | $1,778.28 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,445.44 | $2,344.23 |
11 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 $707.95 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $707.95 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,071.52 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $213.80 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,148.15 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $933.25 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $758.58 | $933.25 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $380.19 Typical High $512.86 | Professional | 80 · Assistant surgeon | $302.00 | $380.19 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $263.03 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $208.93 | $263.03 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $263.03 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $263.03 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $263.03 Typical High $354.81 | Professional | AS · PA/NP assist | $208.93 | $263.03 | $354.81 |
Where South Carolina sits
The same service costs 17.0 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· 43rd of 51
$1,349
AK $5,888TX $347
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.