How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,511Professionalmedian $3,981 · 10th to 90th $447 to $6,166
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 $5,128.61 Median $9,120.11 Typical High $22,908.68 | Facility | None | $5,128.61 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $5,128.61 | Professional | None | $4,365.16 | $5,128.61 | $5,128.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,754.23 Median $3,090.30 Typical High $3,981.07 | Professional | None | $2,754.23 | $3,090.30 | $3,981.07 |
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 $2,754.23 Median $4,365.16 Typical High $7,244.36 | Professional | None | $2,754.23 | $4,365.16 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $10,232.93 | Professional | None | $2,754.23 | $2,951.21 | $10,232.93 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $6,918.31 | Facility | None | $724.44 | $724.44 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $5,011.87 Typical High $5,754.40 | Professional | None | $2,630.27 | $5,011.87 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $3,548.13 Typical High $6,456.54 | Professional | None | $398.11 | $3,548.13 | $6,456.54 |
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 $3,235.94 Median $4,365.16 Typical High $7,585.78 | Professional | None | $3,235.94 | $4,365.16 | $7,585.78 |
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 $2,137.96 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $2,137.96 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $870.96 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,235.94 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $645.65 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $436.52 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,019.95 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $3,019.95 | $3,630.78 | $3,630.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,318.26 Median $2,818.38 Typical High $3,162.28 | Professional | 51 · Multiple procedures | $1,318.26 | $2,818.38 | $3,162.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $1,122.02 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $524.81 | $1,122.02 | $1,258.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $776.25 Typical High $870.96 | Professional | 81 · Minimal assistant surgeon | $371.54 | $776.25 | $870.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $776.25 Typical High $870.96 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $776.25 | $870.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $776.25 Typical High $870.96 | Professional | AS · PA/NP assist | $371.54 | $776.25 | $870.96 |
Where South Carolina sits
The same service costs 21.4 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· 43rd of 51
$3,981
AK $14,454TX $676
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.