How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,148 to $11,220Professionalmedian $295 · 10th to 90th $69 to $479
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 $257.04 Median $10,964.78 Typical High $21,877.62 | Facility | None | $257.04 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $446.68 | Professional | None | $239.88 | $309.03 | $446.68 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,584.89 Median $3,630.78 Typical High $10,232.93 | Facility | None | $1,584.89 | $3,630.78 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $346.74 | Professional | None | $186.21 | $288.40 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,737.80 Typical High $2,691.53 | Facility | None | $630.96 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $457.09 | Professional | None | $218.78 | $309.03 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $891.25 | Professional | None | $331.13 | $354.81 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $1,230.27 Typical High $1,995.26 | Facility | None | $218.78 | $1,230.27 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $426.58 | Professional | None | $288.40 | $371.54 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $338.84 Typical High $575.44 | Professional | None | $33.88 | $338.84 | $575.44 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $478.63 | Professional | None | $186.21 | $302.00 | $478.63 |
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 $120.23 Median $154.88 Typical High $223.87 | Professional | 52 · Reduced service | $120.23 | $154.88 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $61.66 Typical High $89.13 | Professional | 53 · Discontinued | $47.86 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $234.42 Typical High $331.13 | Professional | 54 · Surgery only | $177.83 | $234.42 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $66.07 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $30.90 Typical High $44.67 | Professional | 56 · Pre-op care only | $23.99 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $218.78 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $165.96 | $218.78 | $309.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $186.21 Typical High $269.15 | Professional | 51 · Multiple procedures | $144.54 | $186.21 | $269.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $74.13 Typical High $107.15 | Professional | 80 · Assistant surgeon | $57.54 | $74.13 | $107.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $40.74 Median $51.29 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $40.74 | $51.29 | $75.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $40.74 Median $51.29 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $40.74 | $51.29 | $75.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $51.29 Typical High $75.86 | Professional | AS · PA/NP assist | $40.74 | $51.29 | $75.86 |
Where South Carolina sits
The same service costs 3.7 times more in Wyoming 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· 37th of 51
$309
WY $891TX $240
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.