How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,479 to $17,783Professionalmedian $1,259 · 10th to 90th $178 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 $12,022.64 Typical High $21,877.62 | Facility | None | $1,412.54 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,412.54 | $1,412.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,698.24 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,380.38 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $4,677.35 | Facility | None | $630.96 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,148.15 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $3,311.31 | Facility | None | $1,202.26 | $1,548.82 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,380.38 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $109.65 Median $1,047.13 Typical High $1,548.82 | Professional | None | $109.65 | $1,047.13 | $1,548.82 |
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 $870.96 Median $1,148.15 Typical High $2,041.74 | Professional | None | $870.96 | $1,148.15 | $2,041.74 |
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 $575.44 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $575.44 | $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 $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $114.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $977.24 | $977.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $851.14 Typical High $912.01 | Professional | 51 · Multiple procedures | $691.83 | $851.14 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $338.84 Typical High $363.08 | Professional | 80 · Assistant surgeon | $281.84 | $338.84 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $239.88 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $194.98 | $239.88 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $239.88 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $239.88 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $239.88 Typical High $257.04 | Professional | AS · PA/NP assist | $194.98 | $239.88 | $257.04 |
Where South Carolina sits
The same service costs 5.5 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· 38th of 51
$1,413
AK $4,786TX $871
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.