How much rates vary
Facilitymedian $1,514 · 10th to 90th $490 to $10,233Professionalmedian $174 · 10th to 90th $91 to $288
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 $117.49 Median $4,897.79 Typical High $21,877.62 | Facility | None | $117.49 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $251.19 | Professional | None | $112.20 | $186.21 | $251.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $9,332.54 | Facility | None | $512.86 | $1,479.11 | $9,332.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $223.87 | Professional | None | $81.28 | $147.91 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $2,187.76 | Facility | None | $457.09 | $1,479.11 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $186.21 Typical High $281.84 | Professional | None | $97.72 | $186.21 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $478.63 | Professional | None | $213.80 | $229.09 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $436.52 Typical High $1,096.48 | Facility | None | $117.49 | $436.52 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $245.47 | Professional | None | $190.55 | $239.88 | $245.47 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $426.58 | Professional | None | $213.80 | $281.84 | $426.58 |
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 $83.18 Median $158.49 Typical High $263.03 | Professional | None | $83.18 | $158.49 | $263.03 |
10 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 $54.95 Median $89.13 Typical High $125.89 | Professional | 52 · Reduced service | $54.95 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $36.31 Typical High $50.12 | Professional | 53 · Discontinued | $21.88 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $134.90 Typical High $186.21 | Professional | 54 · Surgery only | $83.18 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.92 Typical High $38.02 | Professional | 55 · Aftercare only | $16.60 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $18.20 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.96 | $18.20 | $25.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $120.23 Typical High $151.36 | Professional | 51 · Multiple procedures | $100.00 | $120.23 | $151.36 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $47.86 Typical High $60.26 | Professional | 80 · Assistant surgeon | $39.81 | $47.86 | $60.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $27.54 Median $33.11 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $27.54 | $33.11 | $42.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $27.54 Median $33.11 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $27.54 | $33.11 | $42.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $33.11 Typical High $42.66 | Professional | AS · PA/NP assist | $27.54 | $33.11 | $42.66 |
Where South Carolina sits
The same service costs 4.0 times more in Alaska than in Washington, DC. 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· 31st of 51
$191
AK $468DC $117
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.