How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $8,511Professionalmedian $955 · 10th to 90th $135 to $1,622
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 $1,174.90 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,174.90 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | None | $954.99 | $1,174.90 | $1,174.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,862.09 | Professional | None | $912.01 | $1,288.25 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,174.90 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,691.53 | Facility | None | $812.83 | $1,174.90 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,288.25 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $831.76 Typical High $1,584.89 | Professional | None | $123.03 | $831.76 | $1,584.89 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,995.26 | Professional | None | $933.25 | $1,148.15 | $1,995.26 |
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 $478.63 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $478.63 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $190.55 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $95.50 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $812.83 | $812.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $645.65 Typical High $891.25 | Professional | 51 · Multiple procedures | $630.96 | $645.65 | $891.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $257.04 Typical High $354.81 | Professional | 80 · Assistant surgeon | $251.19 | $257.04 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $181.97 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $173.78 | $181.97 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $181.97 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $181.97 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $181.97 Typical High $251.19 | Professional | AS · PA/NP assist | $173.78 | $181.97 | $251.19 |
Where South Carolina sits
The same service costs 6.8 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· 46th of 51
$955
AK $3,981TX $589
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.