How much rates vary
Facilitymedian $2,570 · 10th to 90th $676 to $16,218Professionalmedian $1,148 · 10th to 90th $132 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 $1,318.26 Median $5,888.44 Typical High $21,877.62 | Facility | None | $1,318.26 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,318.26 | $1,318.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $15,135.61 | Facility | None | $691.83 | $2,290.87 | $15,135.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,819.70 | Professional | None | $977.24 | $1,318.26 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $3,311.31 | Facility | None | $602.56 | $1,995.26 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,258.93 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $3,090.30 | Facility | None | $588.84 | $933.25 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,348.96 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $977.24 Typical High $1,479.11 | Professional | None | $117.49 | $977.24 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $21,379.62 | Facility | None | $1,445.44 | $4,265.80 | $21,379.62 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,905.46 | Professional | None | $912.01 | $1,174.90 | $1,905.46 |
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 $549.54 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $549.54 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $165.96 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $912.01 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $758.58 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $630.96 | $758.58 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $302.00 Typical High $398.11 | Professional | 80 · Assistant surgeon | $251.19 | $302.00 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $208.93 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $177.83 | $208.93 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $208.93 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $208.93 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $208.93 Typical High $275.42 | Professional | AS · PA/NP assist | $177.83 | $208.93 | $275.42 |
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
$1,202
AK $4,571UT $741
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.