How much rates vary
Facilitymedian $2,138 · 10th to 90th $977 to $18,197Professionalmedian $1,023 · 10th to 90th $158 to $1,549
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 $1,288.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,288.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,288.25 | $1,288.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $5,128.61 Typical High $19,054.61 | Facility | None | $1,047.13 | $5,128.61 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,479.11 | $1,819.70 |
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 $1,288.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,288.25 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,202.26 Typical High $2,137.96 | Facility | None | $794.33 | $1,202.26 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,348.96 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $812.83 Typical High $1,380.38 | Professional | None | $120.23 | $812.83 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,995.26 | Professional | None | $954.99 | $1,174.90 | $1,995.26 |
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 $562.34 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $851.14 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $794.33 | $912.01 | $912.01 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,454.71 Typical High $3,019.95 | Professional | 50 · Both sides | $1,995.26 | $2,454.71 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $812.83 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $660.69 | $812.83 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $323.59 Typical High $398.11 | Professional | 80 · Assistant surgeon | $263.03 | $323.59 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $229.09 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $186.21 | $229.09 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $229.09 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $229.09 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $229.09 Typical High $281.84 | Professional | AS · PA/NP assist | $186.21 | $229.09 | $281.84 |
Where South Carolina sits
The same service costs 7.9 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
$1,122
AK $4,571TX $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.