How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $1,349 · 10th to 90th $162 to $1,950
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 $1,548.82 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,548.82 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,548.82 | $1,548.82 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,348.96 | $1,698.24 |
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 $1,318.26 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,318.26 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,659.59 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,089.30 | Facility | None | $724.44 | $724.44 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,479.11 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,202.26 Typical High $1,995.26 | Professional | None | $114.82 | $1,202.26 | $1,995.26 |
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 $1,096.48 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,348.96 | $2,290.87 |
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 $630.96 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $630.96 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $1,071.52 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $831.76 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $691.83 | $831.76 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $331.13 Typical High $446.68 | Professional | 80 · Assistant surgeon | $275.42 | $331.13 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $234.42 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $190.55 | $234.42 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $234.42 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $234.42 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $234.42 Typical High $309.03 | Professional | AS · PA/NP assist | $190.55 | $234.42 | $309.03 |
Where South Carolina sits
The same service costs 5.4 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· 39th of 51
$1,349
AK $4,571TX $851
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.