How much rates vary
Facilitymedian $1,514 · 10th to 90th $676 to $15,136Professionalmedian $1,230 · 10th to 90th $132 to $1,660
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 $5,888.44 Typical High $21,877.62 | Facility | None | $1,380.38 | $5,888.44 | $21,877.62 |
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 $691.83 Median $1,288.25 Typical High $15,135.61 | Facility | None | $691.83 | $1,288.25 | $15,135.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,348.96 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,698.24 | Facility | None | $602.56 | $1,047.13 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,318.26 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,023.29 Typical High $2,290.87 | Facility | None | $588.84 | $1,023.29 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,445.44 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $1,000.00 Typical High $1,548.82 | Professional | None | $117.49 | $1,000.00 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,995.26 | Professional | None | $977.24 | $1,230.27 | $1,995.26 |
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 $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $204.17 |
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 $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $954.99 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,454.71 Typical High $3,090.30 | Professional | 50 · Both sides | $2,137.96 | $2,454.71 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $812.83 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $724.44 | $812.83 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $323.59 Typical High $416.87 | Professional | 80 · Assistant surgeon | $288.40 | $323.59 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $229.09 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $199.53 | $229.09 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $229.09 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $229.09 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $229.09 Typical High $288.40 | Professional | AS · PA/NP assist | $199.53 | $229.09 | $288.40 |
Where South Carolina sits
The same service costs 6.2 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· 39th of 51
$1,230
AK $4,786UT $776
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.