How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,479 to $19,498Professionalmedian $1,122 · 10th to 90th $151 to $1,622
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 $1,380.38 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,380.38 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,380.38 | $1,380.38 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $14,454.40 | Facility | None | $1,778.28 | $2,951.21 | $14,454.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,148.15 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,248.07 Typical High $7,413.10 | Facility | None | $602.56 | $5,248.07 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,380.38 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $10,715.19 | Facility | None | $1,023.29 | $1,380.38 | $10,715.19 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,621.81 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $870.96 Typical High $1,513.56 | Professional | None | $120.23 | $870.96 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,000.00 | $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 $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $588.84 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $891.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $177.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $831.76 | $977.24 | $977.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,454.71 Typical High $3,235.94 | Professional | 50 · Both sides | $2,187.76 | $2,454.71 | $3,235.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $812.83 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $724.44 | $812.83 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $323.59 Typical High $426.58 | Professional | 80 · Assistant surgeon | $288.40 | $323.59 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $229.09 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $204.17 | $229.09 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $229.09 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $229.09 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $229.09 Typical High $302.00 | Professional | AS · PA/NP assist | $204.17 | $229.09 | $302.00 |
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· 46th of 51
$1,148
AK $5,012TX $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.