How much rates vary
Facilitymedian $955 · 10th to 90th $457 to $8,511Professionalmedian $3,890 · 10th to 90th $447 to $6,026
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 $5,011.87 Median $9,120.11 Typical High $22,908.68 | Facility | None | $5,011.87 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,168.69 | $5,011.87 | $5,011.87 |
BCBS South Carolina Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $3,467.37 Median $3,630.78 Typical High $3,890.45 | Professional | None | $3,467.37 | $3,630.78 | $3,890.45 |
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 $3,981.07 Median $3,981.07 Typical High $6,760.83 | Professional | None | $3,981.07 | $3,981.07 | $6,760.83 |
Medcost Setting Professional Modifier None Typical Low $4,786.30 Median $5,128.61 Typical High $9,772.37 | Professional | None | $4,786.30 | $5,128.61 | $9,772.37 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $6,760.83 | Facility | None | $724.44 | $724.44 | $6,760.83 |
Medcost Setting Professional Modifier None Typical Low $3,981.07 Median $4,786.30 Typical High $5,011.87 | Professional | None | $3,981.07 | $4,786.30 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $3,388.44 Typical High $6,165.95 | Professional | None | $398.11 | $3,388.44 | $6,165.95 |
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 $3,548.13 Median $4,168.69 Typical High $7,079.46 | Professional | None | $3,548.13 | $4,168.69 | $7,079.46 |
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 $2,089.30 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,089.30 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $831.76 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,090.30 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,467.37 | $3,467.37 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,995.26 Median $2,454.71 Typical High $3,019.95 | Professional | 51 · Multiple procedures | $1,995.26 | $2,454.71 | $3,019.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $794.33 Median $977.24 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $794.33 | $977.24 | $1,202.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $549.54 Median $691.83 Typical High $831.76 | Professional | 81 · Minimal assistant surgeon | $549.54 | $691.83 | $831.76 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $549.54 Median $691.83 Typical High $831.76 | Professional | 82 · Assistant surgeon, no resident | $549.54 | $691.83 | $831.76 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $549.54 Median $691.83 Typical High $831.76 | Professional | AS · PA/NP assist | $549.54 | $691.83 | $831.76 |
Where South Carolina sits
The same service costs 21.9 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· 44th of 51
$3,802
AK $14,125TX $646
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.