How much rates vary
Facilitymedian $3,890 · 10th to 90th $813 to $16,596Professionalmedian $1,380 · 10th to 90th $186 to $1,995
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 $1,659.59 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,659.59 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,659.59 | $1,659.59 |
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 $1,230.27 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,584.89 | $2,344.23 |
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 $1,584.89 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,584.89 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,174.90 Typical High $3,890.45 | Facility | None | $630.96 | $1,174.90 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,621.81 | $1,819.70 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,096.48 Typical High $1,819.70 | Professional | None | $162.18 | $1,096.48 | $1,819.70 |
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 $1,174.90 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,548.82 | $2,398.83 |
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 $691.83 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $933.25 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $812.83 | $933.25 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $371.54 Typical High $501.19 | Professional | 80 · Assistant surgeon | $323.59 | $371.54 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $263.03 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $223.87 | $263.03 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $263.03 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $263.03 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $263.03 Typical High $354.81 | Professional | AS · PA/NP assist | $223.87 | $263.03 | $354.81 |
Where South Carolina sits
The same service costs 24.5 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
$1,445
AK $5,754TX $234
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.