How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,318 to $14,454Professionalmedian $1,318 · 10th to 90th $174 to $2,188
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 $1,698.24 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,698.24 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,698.24 | $1,698.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $11,748.98 | Facility | None | $1,778.28 | $2,951.21 | $11,748.98 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,659.59 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,235.94 Typical High $4,677.35 | Facility | None | $602.56 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,445.44 | $1,698.24 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $5,248.07 | Facility | None | $1,258.93 | $1,698.24 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,949.84 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,122.02 Typical High $2,041.74 | Professional | None | $162.18 | $1,122.02 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,698.24 | $2,818.38 |
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 $691.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,202.26 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $1,000.00 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $891.25 | $1,000.00 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $398.11 Typical High $501.19 | Professional | 80 · Assistant surgeon | $354.81 | $398.11 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $281.84 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $251.19 | $281.84 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $281.84 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $281.84 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $281.84 Typical High $354.81 | Professional | AS · PA/NP assist | $251.19 | $281.84 | $354.81 |
Where South Carolina sits
The same service costs 6.5 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
$1,445
AK $5,754TX $891
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.