How much rates vary
Facilitymedian $6,918 · 10th to 90th $2,399 to $33,113Professionalmedian $1,514 · 10th to 90th $245 to $2,239
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 $1,862.09 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,862.09 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,862.09 | $2,089.30 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,630.78 Median $7,244.36 Typical High $36,307.81 | Facility | None | $3,630.78 | $7,244.36 | $36,307.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,445.44 | $1,819.70 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,981.07 Typical High $5,623.41 | Facility | None | $602.56 | $3,981.07 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,862.09 | $1,905.46 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $6,456.54 | Facility | None | $1,659.59 | $2,089.30 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,290.87 | Professional | None | $1,862.09 | $2,137.96 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,174.90 Typical High $1,995.26 | Professional | None | $199.53 | $1,174.90 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,918.31 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,918.31 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,737.80 | $2,818.38 |
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 $812.83 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $812.83 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,202.26 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $239.88 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,318.26 | $1,318.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,467.37 Typical High $4,365.16 | Professional | 50 · Both sides | $3,019.95 | $3,467.37 | $4,365.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,148.15 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $1,000.00 | $1,148.15 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $467.74 Typical High $588.84 | Professional | 80 · Assistant surgeon | $398.11 | $467.74 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $323.59 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $281.84 | $323.59 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $323.59 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $323.59 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $323.59 Typical High $407.38 | Professional | AS · PA/NP assist | $281.84 | $323.59 | $407.38 |
Where South Carolina sits
The same service costs 7.8 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· 40th of 51
$1,698
AK $6,761TX $871
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.