How much rates vary
Facilitymedian $1,905 · 10th to 90th $776 to $7,762Professionalmedian $1,202 · 10th to 90th $229 to $1,778
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 $1,380.38 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,380.38 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,380.38 | $1,380.38 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $7,762.47 | Facility | None | $1,000.00 | $2,570.40 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,202.26 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,819.70 | Facility | None | $602.56 | $1,071.52 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,047.13 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,380.38 Typical High $3,235.94 | Facility | None | $812.83 | $1,380.38 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,348.96 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,148.15 Typical High $1,778.28 | Professional | None | $190.55 | $1,148.15 | $1,778.28 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,819.70 | Professional | None | $891.25 | $1,122.02 | $1,819.70 |
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 $575.44 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $114.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $977.24 | $977.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,344.23 Typical High $3,162.28 | Professional | 50 · Both sides | $1,584.89 | $2,344.23 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $776.25 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $524.81 | $776.25 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $309.03 Typical High $416.87 | Professional | 80 · Assistant surgeon | $208.93 | $309.03 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $218.78 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $147.91 | $218.78 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $218.78 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $218.78 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $218.78 Typical High $295.12 | Professional | AS · PA/NP assist | $147.91 | $218.78 | $295.12 |
Where South Carolina sits
The same service costs 5.8 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· 40th of 51
$1,230
AK $4,898TX $851
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.