How much rates vary
Facilitymedian $3,890 · 10th to 90th $813 to $16,596Professionalmedian $1,318 · 10th to 90th $151 to $1,905
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 $1,584.89 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,584.89 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,584.89 | $1,584.89 |
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 $1,174.90 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,621.81 | $2,089.30 |
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 $1,513.56 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,513.56 | $1,513.56 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,174.90 Typical High $3,715.35 | Facility | None | $630.96 | $1,174.90 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,659.59 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $1,047.13 Typical High $1,737.80 | Professional | None | $120.23 | $1,047.13 | $1,737.80 |
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 $1,122.02 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,445.44 | $2,344.23 |
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 $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $933.25 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $724.44 | $933.25 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $371.54 Typical High $489.78 | Professional | 80 · Assistant surgeon | $288.40 | $371.54 | $489.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $263.03 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $204.17 | $263.03 | $338.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $263.03 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $263.03 | $338.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $263.03 Typical High $338.84 | Professional | AS · PA/NP assist | $204.17 | $263.03 | $338.84 |
Where South Carolina sits
The same service costs 7.2 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
$1,380
AK $5,495TX $759
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.