How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,072 to $20,417Professionalmedian $813 · 10th to 90th $501 to $1,202
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 $812.83 Median $15,135.61 Typical High $24,547.09 | Facility | None | $812.83 | $15,135.61 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $812.83 | Professional | None | $724.44 | $812.83 | $812.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $5,888.44 Typical High $19,498.45 | Facility | None | $1,202.26 | $5,888.44 | $19,498.45 |
BCBS South Carolina Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $933.25 | Professional | None | $616.60 | $794.33 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $4,677.35 | Facility | None | $630.96 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,479.11 | Professional | None | $812.83 | $831.76 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,047.13 Typical High $3,715.35 | Facility | None | $812.83 | $1,047.13 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,122.02 | Professional | None | $851.14 | $977.24 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $776.25 Typical High $1,174.90 | Professional | None | $66.07 | $776.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,513.56 | Professional | None | $691.83 | $870.96 | $1,513.56 |
12 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 $363.08 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $537.03 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $562.34 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,584.89 Typical High $2,187.76 | Professional | 50 · Both sides | $1,380.38 | $1,584.89 | $2,187.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $524.81 Typical High $660.69 | Professional | 51 · Multiple procedures | $457.09 | $524.81 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $208.93 Typical High $269.15 | Professional | 80 · Assistant surgeon | $186.21 | $208.93 | $269.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $147.91 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $128.82 | $147.91 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $147.91 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $147.91 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $147.91 Typical High $186.21 | Professional | AS · PA/NP assist | $128.82 | $147.91 | $186.21 |
Where South Carolina sits
The same service costs 6.5 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
$891
AK $3,467UT $537
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.