How much rates vary
Facilitymedian $871 · 10th to 90th $457 to $8,318Professionalmedian $676 · 10th to 90th $110 to $1,023
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 $794.33 Median $9,120.11 Typical High $22,908.68 | Facility | None | $794.33 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $794.33 | Professional | None | $660.69 | $794.33 | $794.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
BCBS South Carolina Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | None | $630.96 | $630.96 | $724.44 |
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 $616.60 Median $645.65 Typical High $1,071.52 | Professional | None | $616.60 | $645.65 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,548.82 | Professional | None | $794.33 | $851.14 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $1,071.52 | Facility | None | $524.81 | $724.44 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $912.01 | Professional | None | $741.31 | $758.58 | $912.01 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $645.65 Typical High $1,047.13 | Professional | None | $75.86 | $645.65 | $1,047.13 |
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 $537.03 Median $645.65 Typical High $1,096.48 | Professional | None | $537.03 | $645.65 | $1,096.48 |
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 $331.13 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $131.83 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $549.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $380.19 Typical High $478.63 | Professional | 51 · Multiple procedures | $371.54 | $380.19 | $478.63 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $151.36 Typical High $190.55 | Professional | 80 · Assistant surgeon | $147.91 | $151.36 | $190.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $107.15 Typical High $134.90 | Professional | 81 · Minimal assistant surgeon | $104.71 | $107.15 | $134.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $107.15 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $107.15 | $134.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $107.15 Typical High $134.90 | Professional | AS · PA/NP assist | $104.71 | $107.15 | $134.90 |
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· 42nd of 51
$676
AK $2,512TX $468
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.