How much rates vary
Facilitymedian $7,762 · 10th to 90th $977 to $33,113Professionalmedian $1,175 · 10th to 90th $158 to $1,698
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 $1,445.44 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,445.44 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,445.44 | $1,445.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $10,232.93 Typical High $36,307.81 | Facility | None | $1,047.13 | $10,232.93 | $36,307.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,258.93 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $14,791.08 | Facility | None | $630.96 | $2,951.21 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,412.54 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,202.26 Typical High $4,168.69 | Facility | None | $794.33 | $1,202.26 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,659.59 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $933.25 Typical High $1,584.89 | Professional | None | $120.23 | $933.25 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $24,547.09 | Facility | None | $1,819.70 | $6,606.93 | $24,547.09 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,318.26 | $2,137.96 |
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 $616.60 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,000.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,511.89 Typical High $3,311.31 | Professional | 50 · Both sides | $2,238.72 | $2,511.89 | $3,311.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $831.76 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $741.31 | $831.76 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $331.13 Typical High $446.68 | Professional | 80 · Assistant surgeon | $295.12 | $331.13 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $234.42 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $208.93 | $234.42 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $234.42 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $234.42 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $234.42 Typical High $309.03 | Professional | AS · PA/NP assist | $208.93 | $234.42 | $309.03 |
Where South Carolina sits
The same service costs 7.6 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
$1,230
AK $5,129TX $676
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.