How much rates vary
Facilitymedian $912 · 10th to 90th $447 to $7,586Professionalmedian $398 · 10th to 90th $49 to $562
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 $467.74 Median $5,623.41 Typical High $21,877.62 | Facility | None | $467.74 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | None | $398.11 | $467.74 | $467.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $7,762.47 | Facility | None | $501.19 | $912.01 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $562.34 | Professional | None | $380.19 | $436.52 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $2,511.89 | Facility | None | $457.09 | $1,479.11 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $691.83 | Professional | None | $426.58 | $426.58 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $512.86 Typical High $1,148.15 | Facility | None | $407.38 | $512.86 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $549.54 | Professional | None | $457.09 | $467.74 | $549.54 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $309.03 Typical High $537.03 | Professional | None | $38.90 | $309.03 | $537.03 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,606.93 | Facility | None | $302.00 | $1,122.02 | $6,606.93 |
United Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $676.08 | Professional | None | $331.13 | $407.38 | $676.08 |
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 $199.53 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $81.28 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $39.81 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $331.13 | $331.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $794.33 Typical High $1,096.48 | Professional | 50 · Both sides | $676.08 | $794.33 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $263.03 Typical High $363.08 | Professional | 51 · Multiple procedures | $229.09 | $263.03 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $104.71 Typical High $147.91 | Professional | 80 · Assistant surgeon | $91.20 | $104.71 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $63.10 Median $74.13 Typical High $102.33 | Professional | 81 · Minimal assistant surgeon | $63.10 | $74.13 | $102.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $63.10 Median $74.13 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $63.10 | $74.13 | $102.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $74.13 Typical High $102.33 | Professional | AS · PA/NP assist | $63.10 | $74.13 | $102.33 |
Where South Carolina sits
The same service costs 8.1 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
$427
AK $1,698TX $209
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.