How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,710Professionalmedian $1,622 · 10th to 90th $166 to $2,570
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 $1,949.84 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,949.84 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,949.84 | $1,949.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Facility | None | $10,964.78 | $10,964.78 | $10,964.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,445.44 | $2,089.30 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $3,630.78 | Professional | None | $1,862.09 | $2,041.74 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $4,786.30 | Facility | None | $1,548.82 | $1,949.84 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,995.26 | $2,238.72 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,380.38 Typical High $2,454.71 | Professional | None | $151.36 | $1,380.38 | $2,454.71 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,659.59 | $2,137.96 | $3,548.13 |
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 $851.14 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,288.25 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,348.96 | $1,348.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $3,467.37 Typical High $4,677.35 | Professional | 50 · Both sides | $3,162.28 | $3,467.37 | $4,677.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,148.15 Typical High $1,548.82 | Professional | 51 · Multiple procedures | $1,047.13 | $1,148.15 | $1,548.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $467.74 Typical High $630.96 | Professional | 80 · Assistant surgeon | $426.58 | $467.74 | $630.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $323.59 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $295.12 | $323.59 | $436.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $323.59 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $323.59 | $436.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $323.59 Typical High $436.52 | Professional | AS · PA/NP assist | $295.12 | $323.59 | $436.52 |
Where South Carolina sits
The same service costs 21.9 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· 46th of 51
$1,585
AK $7,079TX $324
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.