How much rates vary
Facilitymedian $1,259 · 10th to 90th $457 to $9,333Professionalmedian $1,175 · 10th to 90th $158 to $1,738
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 $12,022.64 Typical High $21,877.62 | Facility | None | $1,318.26 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,318.26 | $1,318.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Facility | None | $7,762.47 | $7,762.47 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $933.25 | $1,288.25 | $2,041.74 |
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 $1,230.27 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,230.27 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,318.26 Typical High $2,951.21 | Facility | None | $977.24 | $1,318.26 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,412.54 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,023.29 Typical High $1,659.59 | Professional | None | $123.03 | $1,023.29 | $1,659.59 |
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 $1,047.13 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,318.26 | $2,238.72 |
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 $524.81 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $524.81 | $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 $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $794.33 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $104.71 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $741.31 | $933.25 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $707.95 Typical High $954.99 | Professional | 51 · Multiple procedures | $660.69 | $707.95 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $281.84 Typical High $380.19 | Professional | 80 · Assistant surgeon | $263.03 | $281.84 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $199.53 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $186.21 | $199.53 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $199.53 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $199.53 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $199.53 Typical High $269.15 | Professional | AS · PA/NP assist | $186.21 | $199.53 | $269.15 |
Where South Carolina sits
The same service costs 5.9 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· 40th of 51
$1,175
AK $4,365TX $741
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.