How much rates vary
Facilitymedian $3,890 · 10th to 90th $813 to $16,596Professionalmedian $1,259 · 10th to 90th $151 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 $1,548.82 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,548.82 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,548.82 | $1,548.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $4,365.16 Typical High $15,135.61 | Facility | None | $851.14 | $4,365.16 | $15,135.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,548.82 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $6,309.57 | Facility | None | $602.56 | $2,398.83 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,445.44 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,071.52 Typical High $3,630.78 | Facility | None | $630.96 | $1,071.52 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,584.89 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $1,000.00 Typical High $1,659.59 | Professional | None | $120.23 | $1,000.00 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,380.38 | $2,238.72 |
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 $645.65 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $257.04 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $1,096.48 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $851.14 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $691.83 | $851.14 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $346.74 Typical High $467.74 | Professional | 80 · Assistant surgeon | $275.42 | $346.74 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $239.88 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $194.98 | $239.88 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $239.88 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $239.88 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $239.88 Typical High $331.13 | Professional | AS · PA/NP assist | $194.98 | $239.88 | $331.13 |
Where South Carolina sits
The same service costs 11.0 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· 44th of 51
$1,318
AK $5,370TX $490
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.