How much rates vary
Facilitymedian $1,288 · 10th to 90th $676 to $8,913Professionalmedian $1,072 · 10th to 90th $182 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 $1,258.93 Median $5,888.44 Typical High $21,877.62 | Facility | None | $1,258.93 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,258.93 | $1,258.93 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $7,585.78 | Facility | None | $691.83 | $1,288.25 | $7,585.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,047.13 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,096.48 Typical High $1,737.80 | Facility | None | $602.56 | $1,096.48 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,949.84 | Professional | None | $933.25 | $954.99 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $831.76 Typical High $1,737.80 | Facility | None | $588.84 | $831.76 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,230.27 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,023.29 Typical High $1,584.89 | Professional | None | $151.36 | $1,023.29 | $1,584.89 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,698.24 | Professional | None | $851.14 | $1,023.29 | $1,698.24 |
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 $524.81 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $213.80 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $891.25 | $891.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $707.95 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $512.86 | $707.95 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $281.84 Typical High $436.52 | Professional | 80 · Assistant surgeon | $204.17 | $281.84 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $199.53 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $141.25 | $199.53 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $199.53 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $199.53 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $199.53 Typical High $302.00 | Professional | AS · PA/NP assist | $141.25 | $199.53 | $302.00 |
Where South Carolina sits
The same service costs 5.9 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· 43rd of 51
$1,072
AK $4,467TX $759
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.