How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $1,820 · 10th to 90th $275 to $2,570
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 $2,041.74 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,041.74 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,698.24 | $2,041.74 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,862.09 | $2,089.30 |
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 $1,737.80 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,737.80 | $1,778.28 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,398.83 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,754.23 | Facility | None | $724.44 | $724.44 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,187.76 | Professional | None | $1,737.80 | $2,137.96 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,621.81 Typical High $2,630.27 | Professional | None | $190.55 | $1,621.81 | $2,630.27 |
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 $1,479.11 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,737.80 | $3,019.95 |
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 $851.14 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $851.14 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,288.25 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $257.04 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,445.44 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $1,071.52 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $870.96 | $1,071.52 | $1,230.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $426.58 Typical High $489.78 | Professional | 80 · Assistant surgeon | $346.74 | $426.58 | $489.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $302.00 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $245.47 | $302.00 | $346.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $302.00 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $302.00 | $346.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $302.00 Typical High $346.74 | Professional | AS · PA/NP assist | $245.47 | $302.00 | $346.74 |
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· 40th of 51
$1,820
AK $6,026TX $1,122
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.