How much rates vary
Facilitymedian $603 · 10th to 90th $102 to $1,862Professionalmedian $145 · 10th to 90th $102 to $257
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 $144.54 Median $4,897.79 Typical High $21,877.62 | Facility | None | $144.54 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $190.55 | Professional | None | $128.82 | $158.49 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
BCBS South Carolina Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $1,479.11 | Facility | None | $489.78 | $831.76 | $1,479.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $281.84 | Professional | None | $100.00 | $117.49 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $109.65 Typical High $173.78 | Facility | None | $75.86 | $109.65 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $251.19 | Professional | None | $93.33 | $141.25 | $251.19 |
Medcost Setting Facility Modifier None Typical Low $109.65 Median $169.82 Typical High $218.78 | Facility | None | $109.65 | $169.82 | $218.78 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $194.98 | Professional | None | $144.54 | $169.82 | $194.98 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $245.47 | Professional | None | $104.71 | $162.18 | $245.47 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $245.47 | Professional | None | $107.15 | $141.25 | $245.47 |
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 $72.44 Median $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $72.44 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $36.31 | Professional | 53 · Discontinued | $28.84 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $109.65 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $102.33 | $102.33 | $128.82 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $263.03 Typical High $323.59 | Professional | 50 · Both sides | $213.80 | $263.03 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $87.10 Typical High $107.15 | Professional | 51 · Multiple procedures | $72.44 | $87.10 | $107.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $35.48 Typical High $42.66 | Professional | 80 · Assistant surgeon | $28.84 | $35.48 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $24.55 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $19.95 | $24.55 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $24.55 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $24.55 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.95 Median $24.55 Typical High $30.20 | Professional | AS · PA/NP assist | $19.95 | $24.55 | $30.20 |
Where South Carolina sits
The same service costs 4.1 times more in Alaska than in Florida. 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· 37th of 51
$148
AK $468FL $115
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.