How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,413 to $17,783Professionalmedian $1,072 · 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 $1,348.96 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,348.96 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,348.96 | $1,348.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $14,125.38 | Facility | None | $1,778.28 | $2,951.21 | $14,125.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,128.61 Typical High $7,244.36 | Facility | None | $602.56 | $5,128.61 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,445.44 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $10,471.29 | Facility | None | $1,148.15 | $1,348.96 | $10,471.29 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,659.59 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $831.76 Typical High $1,412.54 | Professional | None | $120.23 | $831.76 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,041.74 | Professional | None | $977.24 | $1,258.93 | $2,041.74 |
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 $588.84 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $954.99 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,754.23 Typical High $3,162.28 | Professional | 50 · Both sides | $2,187.76 | $2,754.23 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $912.01 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $741.31 | $912.01 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $363.08 Typical High $416.87 | Professional | 80 · Assistant surgeon | $295.12 | $363.08 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $257.04 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $204.17 | $257.04 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $257.04 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $257.04 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $257.04 Typical High $295.12 | Professional | AS · PA/NP assist | $204.17 | $257.04 | $295.12 |
Where South Carolina sits
The same service costs 8.7 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
$1,175
AK $4,786TX $550
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.