How much rates vary
Facilitymedian $3,020 · 10th to 90th $813 to $15,136Professionalmedian $1,096 · 10th to 90th $151 to $1,622
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 $1,288.25 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,288.25 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | None | $977.24 | $1,288.25 | $1,288.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $4,168.69 Typical High $14,454.40 | Facility | None | $851.14 | $4,168.69 | $14,454.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $1,995.26 | Professional | None | $870.96 | $1,445.44 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,951.21 Typical High $4,168.69 | Facility | None | $602.56 | $2,951.21 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,174.90 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $2,754.23 | Facility | None | $630.96 | $1,000.00 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,348.96 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $954.99 Typical High $1,548.82 | Professional | None | $123.03 | $954.99 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,202.26 | $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 $489.78 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $489.78 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $194.98 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $741.31 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $97.72 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $691.83 | $912.01 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $691.83 Typical High $891.25 | Professional | 51 · Multiple procedures | $562.34 | $691.83 | $891.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $275.42 Typical High $354.81 | Professional | 80 · Assistant surgeon | $229.09 | $275.42 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $194.98 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $158.49 | $194.98 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $194.98 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $194.98 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $194.98 Typical High $251.19 | Professional | AS · PA/NP assist | $158.49 | $194.98 | $251.19 |
Where South Carolina sits
The same service costs 5.6 times more in Alaska than in Utah. 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
$1,175
AK $4,074UT $724
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.