How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,096 to $17,783Professionalmedian $1,202 · 10th to 90th $155 to $1,950
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 $1,548.82 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,548.82 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,548.82 | $1,548.82 |
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 $1,096.48 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,318.26 | $1,995.26 |
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 $1,258.93 Median $1,318.26 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,318.26 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,380.38 Typical High $3,467.37 | Facility | None | $851.14 | $1,380.38 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,479.11 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $1,023.29 Typical High $1,862.09 | Professional | None | $134.90 | $1,023.29 | $1,862.09 |
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 $1,174.90 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,445.44 | $2,570.40 |
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 $630.96 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $1,071.52 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $741.31 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $676.08 | $741.31 | $1,348.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $295.12 Typical High $537.03 | Professional | 80 · Assistant surgeon | $269.15 | $295.12 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $204.17 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $190.55 | $204.17 | $371.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $204.17 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $204.17 | $371.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $204.17 Typical High $371.54 | Professional | AS · PA/NP assist | $190.55 | $204.17 | $371.54 |
Where South Carolina sits
The same service costs 6.6 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· 45th of 51
$1,288
AK $5,248TX $794
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.