How much rates vary
Facilitymedian $7,079 · 10th to 90th $2,399 to $30,200Professionalmedian $1,175 · 10th to 90th $132 to $1,820
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 $1,479.11 Median $15,135.61 Typical High $24,547.09 | Facility | None | $1,479.11 | $15,135.61 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,479.11 | $1,479.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,715.35 Median $7,079.46 Typical High $34,673.69 | Facility | None | $3,715.35 | $7,079.46 | $34,673.69 |
BCBS South Carolina Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $7,762.47 | Facility | None | $602.56 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,258.93 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,621.81 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,467.37 | Facility | None | $724.44 | $724.44 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,479.11 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $1,000.00 Typical High $1,862.09 | Professional | None | $117.49 | $1,000.00 | $1,862.09 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $11,220.18 Typical High $33,884.42 | Facility | None | $3,311.31 | $11,220.18 | $33,884.42 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,258.93 | $2,137.96 |
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 $616.60 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $123.03 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $1,047.13 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $758.58 Typical High $891.25 | Professional | 51 · Multiple procedures | $630.96 | $758.58 | $891.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $302.00 Typical High $354.81 | Professional | 80 · Assistant surgeon | $251.19 | $302.00 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $213.80 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $177.83 | $213.80 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $213.80 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $213.80 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $213.80 Typical High $251.19 | Professional | AS · PA/NP assist | $177.83 | $213.80 | $251.19 |
Where South Carolina sits
The same service costs 25.7 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
$1,230
AK $5,129TX $200
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.