How much rates vary
Facilitymedian $1,023 · 10th to 90th $457 to $9,333Professionalmedian $912 · 10th to 90th $158 to $1,380
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 $1,023.29 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,023.29 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | None | $912.01 | $1,023.29 | $1,023.29 |
BCBS South Carolina Setting Facility Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $18,197.01 | Facility | None | $18,197.01 | $18,197.01 | $18,197.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,318.26 | Professional | None | $776.25 | $794.33 | $1,318.26 |
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 $977.24 Median $1,000.00 Typical High $1,862.09 | Professional | None | $977.24 | $1,000.00 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $2,511.89 | Facility | None | $794.33 | $1,023.29 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,122.02 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $812.83 Typical High $1,348.96 | Professional | None | $123.03 | $812.83 | $1,348.96 |
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 $870.96 Median $1,071.52 Typical High $1,862.09 | Professional | None | $870.96 | $1,071.52 | $1,862.09 |
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 $457.09 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $602.56 Typical High $812.83 | Professional | 51 · Multiple procedures | $562.34 | $602.56 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $239.88 Typical High $331.13 | Professional | 80 · Assistant surgeon | $223.87 | $239.88 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $169.82 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $158.49 | $169.82 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $169.82 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $169.82 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $169.82 Typical High $229.09 | Professional | AS · PA/NP assist | $158.49 | $169.82 | $229.09 |
Where South Carolina sits
The same service costs 6.3 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· 46th of 51
$912
AK $3,715UT $589
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.