How much rates vary
Facilitymedian $2,399 · 10th to 90th $813 to $15,849Professionalmedian $832 · 10th to 90th $102 to $1,202
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 $954.99 Median $10,000.00 Typical High $21,877.62 | Facility | None | $954.99 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,071.52 | Professional | None | $724.44 | $954.99 | $1,071.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,715.35 Typical High $14,454.40 | Facility | None | $851.14 | $3,715.35 | $14,454.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,479.11 | Professional | None | $660.69 | $1,047.13 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,630.27 | Facility | None | $602.56 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,621.81 | Professional | None | $851.14 | $870.96 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $2,238.72 | Facility | None | $630.96 | $954.99 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,202.26 | Professional | None | $831.76 | $933.25 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $724.44 Typical High $1,202.26 | Professional | None | $81.28 | $724.44 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $21,379.62 | Facility | None | $1,445.44 | $4,265.80 | $21,379.62 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,548.82 | Professional | None | $741.31 | $891.25 | $1,548.82 |
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 $363.08 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $549.54 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $512.86 | $676.08 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $501.19 Typical High $660.69 | Professional | 51 · Multiple procedures | $416.87 | $501.19 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $263.03 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $138.04 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $117.49 | $138.04 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $138.04 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $138.04 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $186.21 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $186.21 |
Where South Carolina sits
The same service costs 7.9 times more in Oklahoma 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
$891
OK $4,169UT $525
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.