How much rates vary
Facilitymedian $1,230 · 10th to 90th $437 to $8,511Professionalmedian $1,622 · 10th to 90th $214 to $2,399
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 $1,949.84 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,949.84 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,949.84 | $1,949.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,995.26 | $2,951.21 |
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 $1,698.24 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,698.24 | $1,737.80 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $4,168.69 | Facility | None | $1,380.38 | $1,949.84 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,995.26 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,412.54 Typical High $2,344.23 | Professional | None | $162.18 | $1,412.54 | $2,344.23 |
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 $1,778.28 Typical High $3,090.30 | Professional | None | $1,479.11 | $1,778.28 | $3,090.30 |
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 $741.31 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $741.31 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $295.12 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,096.48 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $218.78 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $147.91 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,348.96 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $1,023.29 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $831.76 | $1,023.29 | $1,348.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $407.38 Typical High $537.03 | Professional | 80 · Assistant surgeon | $331.13 | $407.38 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $288.40 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $234.42 | $288.40 | $371.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $288.40 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $288.40 | $371.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $288.40 Typical High $371.54 | Professional | AS · PA/NP assist | $234.42 | $288.40 | $371.54 |
Where South Carolina sits
The same service costs 6.0 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
$1,622
AK $6,026TX $1,000
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.