How much rates vary
Facilitymedian $1,905 · 10th to 90th $871 to $10,233Professionalmedian $229 · 10th to 90th $158 to $339
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 $251.19 Median $8,912.51 Typical High $20,417.38 | Facility | None | $251.19 | $8,912.51 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $295.12 | Professional | None | $208.93 | $251.19 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $186.21 | Professional | None | $102.33 | $186.21 | $186.21 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $7,762.47 | Facility | None | $1,047.13 | $1,905.46 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $338.84 | Professional | None | $186.21 | $229.09 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,659.59 Typical High $2,691.53 | Facility | None | $630.96 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $354.81 | Professional | None | $218.78 | $218.78 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $489.78 | Professional | None | $281.84 | $302.00 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $812.83 Typical High $2,089.30 | Facility | None | $239.88 | $812.83 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $354.81 | Professional | None | $245.47 | $257.04 | $354.81 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $316.23 | Professional | None | $138.04 | $204.17 | $316.23 |
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 $177.83 Median $213.80 Typical High $371.54 | Professional | None | $177.83 | $213.80 | $371.54 |
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 $102.33 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $41.69 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $30.90 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $20.89 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $144.54 | $177.83 | $177.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $151.36 Typical High $177.83 | Professional | 51 · Multiple procedures | $128.82 | $151.36 | $177.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $61.66 Typical High $70.79 | Professional | 80 · Assistant surgeon | $51.29 | $61.66 | $70.79 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $42.66 Typical High $50.12 | Professional | 81 · Minimal assistant surgeon | $35.48 | $42.66 | $50.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $42.66 Typical High $50.12 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $42.66 | $50.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $42.66 Typical High $50.12 | Professional | AS · PA/NP assist | $35.48 | $42.66 | $50.12 |
Where South Carolina sits
The same service costs 5.6 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· 39th of 51
$229
AK $871UT $155
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.