How much rates vary
Facilitymedian $3,467 · 10th to 90th $977 to $17,783Professionalmedian $1,096 · 10th to 90th $135 to $1,778
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 $1,412.54 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,412.54 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,174.90 | $1,412.54 | $1,412.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,047.13 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,122.02 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $4,677.35 | Facility | None | $630.96 | $2,951.21 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,202.26 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,202.26 Typical High $3,235.94 | Facility | None | $794.33 | $1,202.26 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,348.96 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $954.99 Typical High $1,698.24 | Professional | None | $125.89 | $954.99 | $1,698.24 |
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 $1,071.52 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,318.26 | $2,290.87 |
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 $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $1,000.00 | $1,000.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,041.74 Typical High $3,162.28 | Professional | 50 · Both sides | $1,995.26 | $2,041.74 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $676.08 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $660.69 | $676.08 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $269.15 Typical High $416.87 | Professional | 80 · Assistant surgeon | $263.03 | $269.15 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $190.55 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $186.21 | $190.55 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $190.55 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $190.55 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $190.55 Typical High $295.12 | Professional | AS · PA/NP assist | $186.21 | $190.55 | $295.12 |
Where South Carolina sits
The same service costs 6.9 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
$1,148
AK $4,786TX $692
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.