How much rates vary
Facilitymedian $2,239 · 10th to 90th $851 to $10,000Professionalmedian $331 · 10th to 90th $240 to $457
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 $346.74 Median $436.52 Typical High $20,417.38 | Facility | None | $346.74 | $436.52 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $416.87 | Professional | None | $281.84 | $346.74 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $288.40 | Professional | None | $251.19 | $275.42 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $2,238.72 Typical High $8,317.64 | Facility | None | $1,202.26 | $2,238.72 | $8,317.64 |
BCBS South Carolina Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $446.68 | Professional | None | $251.19 | $354.81 | $446.68 |
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 $309.03 Median $309.03 Typical High $489.78 | Professional | None | $309.03 | $309.03 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $676.08 | Professional | None | $407.38 | $436.52 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $741.31 Typical High $3,890.45 | Facility | None | $331.13 | $741.31 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $537.03 | Professional | None | $338.84 | $371.54 | $537.03 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $446.68 | Professional | None | $199.53 | $288.40 | $446.68 |
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 $245.47 Median $295.12 Typical High $524.81 | Professional | None | $245.47 | $295.12 | $524.81 |
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 $141.25 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $57.54 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $199.53 | $245.47 | $245.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $208.93 Typical High $269.15 | Professional | 51 · Multiple procedures | $181.97 | $208.93 | $269.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $83.18 Typical High $107.15 | Professional | 80 · Assistant surgeon | $72.44 | $83.18 | $107.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $58.88 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $51.29 | $58.88 | $75.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $58.88 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $58.88 | $75.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $58.88 Typical High $75.86 | Professional | AS · PA/NP assist | $51.29 | $58.88 | $75.86 |
Where South Carolina sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 34th of 51
$347
AK $1,202UT $219
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.