How much rates vary
Facilitymedian $6,918 · 10th to 90th $2,399 to $21,380Professionalmedian $1,000 · 10th to 90th $102 to $1,445
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 $1,258.93 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,258.93 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,258.93 | $1,258.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,630.78 Median $7,079.46 Typical High $20,417.38 | Facility | None | $3,630.78 | $7,079.46 | $20,417.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,621.81 | Professional | None | $977.24 | $1,258.93 | $1,621.81 |
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 $1,122.02 Median $1,122.02 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,122.02 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,258.93 Typical High $6,456.54 | Facility | None | $870.96 | $1,258.93 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,380.38 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $776.25 Typical High $1,348.96 | Professional | None | $79.43 | $776.25 | $1,348.96 |
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 $851.14 Median $1,096.48 Typical High $1,819.70 | Professional | None | $851.14 | $1,096.48 | $1,819.70 |
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 $537.03 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $537.03 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $162.18 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $870.96 | $870.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,137.96 Typical High $2,951.21 | Professional | 50 · Both sides | $1,778.28 | $2,137.96 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $707.95 Typical High $977.24 | Professional | 51 · Multiple procedures | $602.56 | $707.95 | $977.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $281.84 Typical High $389.05 | Professional | 80 · Assistant surgeon | $239.88 | $281.84 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $199.53 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $165.96 | $199.53 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $199.53 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $199.53 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $275.42 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $275.42 |
Where South Carolina sits
The same service costs 13.8 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· 42nd of 51
$1,122
AK $4,467TX $324
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.