How much rates vary
Facilitymedian $1,778 · 10th to 90th $676 to $13,183Professionalmedian $1,072 · 10th to 90th $166 to $1,660
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 $1,318.26 Median $5,888.44 Typical High $21,877.62 | Facility | None | $1,318.26 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,318.26 | $1,318.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,479.11 Typical High $13,182.57 | Facility | None | $691.83 | $1,479.11 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Professional | None | $891.25 | $933.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,548.82 Typical High $2,187.76 | Facility | None | $602.56 | $1,548.82 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,071.52 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,258.93 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,862.09 | Facility | None | $588.84 | $851.14 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,258.93 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,023.29 Typical High $1,698.24 | Professional | None | $114.82 | $1,023.29 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,819.70 | Professional | None | $912.01 | $1,096.48 | $1,819.70 |
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 $537.03 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $213.80 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $912.01 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $645.65 Typical High $794.33 | Professional | 51 · Multiple procedures | $524.81 | $645.65 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $257.04 Typical High $316.23 | Professional | 80 · Assistant surgeon | $208.93 | $257.04 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $181.97 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $147.91 | $181.97 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $181.97 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $181.97 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $223.87 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $223.87 |
Where South Carolina sits
The same service costs 5.2 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· 41st of 51
$1,072
AK $3,981TX $759
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.