How much rates vary
Facilitymedian $955 · 10th to 90th $457 to $8,318Professionalmedian $1,445 · 10th to 90th $214 to $2,291
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 $1,819.70 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,819.70 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,819.70 | $1,819.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,348.96 | $1,513.56 |
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 $1,445.44 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,445.44 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,698.24 | $1,819.70 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,454.71 | Facility | None | $724.44 | $724.44 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,737.80 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,412.54 Typical High $2,398.83 | Professional | None | $151.36 | $1,412.54 | $2,398.83 |
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 $1,258.93 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,513.56 | $2,570.40 |
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 $758.58 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $758.58 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,148.15 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $229.09 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $151.36 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,258.93 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $891.25 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $741.31 | $891.25 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $354.81 Typical High $436.52 | Professional | 80 · Assistant surgeon | $295.12 | $354.81 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $251.19 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $208.93 | $251.19 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $251.19 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $251.19 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $251.19 Typical High $309.03 | Professional | AS · PA/NP assist | $208.93 | $251.19 | $309.03 |
Where South Carolina sits
The same service costs 5.1 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· 44th of 51
$1,445
AK $5,129TX $1,000
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.