How much rates vary
Facilitymedian $1,230 · 10th to 90th $447 to $2,512Professionalmedian $891 · 10th to 90th $115 to $1,349
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 $1,230.27 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,230.27 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,202.26 | $1,230.27 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $812.83 Median $1,445.44 Typical High $2,454.71 | Facility | None | $812.83 | $1,445.44 | $2,454.71 |
BCBS South Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,148.15 | Professional | None | $812.83 | $1,000.00 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $2,238.72 | Facility | None | $602.56 | $1,380.38 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,737.80 | Professional | None | $758.58 | $891.25 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $794.33 Typical High $1,698.24 | Facility | None | $257.04 | $794.33 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,174.90 | Professional | None | $831.76 | $1,096.48 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $724.44 Typical High $1,348.96 | Professional | None | $102.33 | $724.44 | $1,348.96 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,778.28 | Professional | None | $794.33 | $1,000.00 | $1,778.28 |
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 $602.56 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $602.56 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $239.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $851.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,659.59 Typical High $2,089.30 | Professional | 50 · Both sides | $1,258.93 | $1,659.59 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $549.54 Typical High $691.83 | Professional | 51 · Multiple procedures | $416.87 | $549.54 | $691.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $218.78 Typical High $275.42 | Professional | 80 · Assistant surgeon | $169.82 | $218.78 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $154.88 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $117.49 | $154.88 | $194.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $154.88 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $154.88 | $194.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $154.88 Typical High $194.98 | Professional | AS · PA/NP assist | $117.49 | $154.88 | $194.98 |
Where South Carolina sits
The same service costs 7.2 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· 41st of 51
$955
AK $3,890UT $537
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.