How much rates vary
Facilitymedian $832 · 10th to 90th $457 to $4,074Professionalmedian $191 · 10th to 90th $138 to $324
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 $162.18 Median $4,897.79 Typical High $21,877.62 | Facility | None | $162.18 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $190.55 | Professional | None | $154.88 | $162.18 | $190.55 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $3,162.28 | Facility | None | $512.86 | $870.96 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $218.78 | Professional | None | $123.03 | $173.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,174.90 | Facility | None | $457.09 | $741.31 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $363.08 | Professional | None | $147.91 | $181.97 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $354.81 Typical High $630.96 | Facility | None | $141.25 | $354.81 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $245.47 | Professional | None | $165.96 | $199.53 | $245.47 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | None | $147.91 | $223.87 | $338.84 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $331.13 | Professional | None | $144.54 | $190.55 | $331.13 |
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 $77.62 Median $81.28 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $30.90 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $123.03 Typical High $144.54 | Professional | 54 · Surgery only | $114.82 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $24.55 Typical High $28.84 | Professional | 55 · Aftercare only | $22.91 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.49 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $114.82 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $107.15 | $114.82 | $134.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $100.00 Typical High $162.18 | Professional | 51 · Multiple procedures | $83.18 | $100.00 | $162.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $39.81 Typical High $66.07 | Professional | 80 · Assistant surgeon | $33.88 | $39.81 | $66.07 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.44 Median $27.54 Typical High $45.71 | Professional | 81 · Minimal assistant surgeon | $23.44 | $27.54 | $45.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.44 Median $27.54 Typical High $45.71 | Professional | 82 · Assistant surgeon, no resident | $23.44 | $27.54 | $45.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $27.54 Typical High $45.71 | Professional | AS · PA/NP assist | $23.44 | $27.54 | $45.71 |
Where South Carolina sits
The same service costs 4.6 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· 38th of 51
$209
AK $759UT $166
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.