How much rates vary
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 $1,862.09 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,862.09 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,862.09 | $1,862.09 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,905.46 | $2,089.30 |
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 $1,548.82 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,548.82 | $1,621.81 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,089.30 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,570.40 | Facility | None | $724.44 | $724.44 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,737.80 | $1,862.09 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,288.25 Typical High $2,344.23 | Professional | None | $151.36 | $1,288.25 | $2,344.23 |
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 $1,318.26 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,584.89 | $2,691.53 |
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 $794.33 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,174.90 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,318.26 | $1,318.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $977.24 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $870.96 | $977.24 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $389.05 Typical High $562.34 | Professional | 80 · Assistant surgeon | $346.74 | $389.05 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $269.15 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $239.88 | $269.15 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $269.15 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $269.15 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $269.15 Typical High $389.05 | Professional | AS · PA/NP assist | $239.88 | $269.15 | $389.05 |
Where South Carolina sits
The same service costs 20.9 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· 42nd of 51
$1,549
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.