How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,096 to $17,783Professionalmedian $1,230 · 10th to 90th $158 to $2,089
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 $1,621.81 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,621.81 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,621.81 | $1,621.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,202.26 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,202.26 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $4,677.35 | Facility | None | $630.96 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,288.25 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,380.38 Typical High $3,630.78 | Facility | None | $851.14 | $1,380.38 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,412.54 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $1,122.02 Typical High $2,089.30 | Professional | None | $134.90 | $1,122.02 | $2,089.30 |
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 $1,148.15 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,479.11 | $2,630.27 |
11 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 $660.69 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,122.02 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $707.95 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $588.84 | $707.95 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $281.84 Typical High $467.74 | Professional | 80 · Assistant surgeon | $234.42 | $281.84 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $194.98 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $165.96 | $194.98 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $194.98 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $194.98 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $331.13 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $331.13 |
Where South Carolina sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$1,288
AK $5,495UT $933
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.