How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,072 to $13,804Professionalmedian $933 · 10th to 90th $102 to $1,380
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 $1,174.90 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,174.90 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,023.29 | $1,174.90 | $1,174.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $4,786.30 Typical High $12,882.50 | Facility | None | $1,202.26 | $4,786.30 | $12,882.50 |
BCBS South Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,621.81 | Professional | None | $912.01 | $1,288.25 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,623.41 Typical High $7,943.28 | Facility | None | $630.96 | $5,623.41 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,174.90 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,174.90 Typical High $2,818.38 | Facility | None | $912.01 | $1,174.90 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,230.27 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $741.31 Typical High $1,258.93 | Professional | None | $79.43 | $741.31 | $1,258.93 |
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 $851.14 Median $1,071.52 Typical High $1,737.80 | Professional | None | $851.14 | $1,071.52 | $1,737.80 |
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 $501.19 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $204.17 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $831.76 | $831.76 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,187.76 Typical High $2,754.23 | Professional | 50 · Both sides | $1,621.81 | $2,187.76 | $2,754.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $724.44 Typical High $912.01 | Professional | 51 · Multiple procedures | $537.03 | $724.44 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $288.40 Typical High $371.54 | Professional | 80 · Assistant surgeon | $213.80 | $288.40 | $371.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $204.17 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $151.36 | $204.17 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $204.17 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $204.17 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $204.17 Typical High $257.04 | Professional | AS · PA/NP assist | $151.36 | $204.17 | $257.04 |
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· 45th of 51
$1,047
AK $4,266TX $537
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.