How much rates vary
Facilitymedian $2,630 · 10th to 90th $955 to $15,849Professionalmedian $1,072 · 10th to 90th $158 to $1,549
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 $954.99 Median $1,230.27 Typical High $1,348.96 | Professional | None | $954.99 | $1,230.27 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,786.30 Typical High $14,454.40 | Facility | None | $1,047.13 | $4,786.30 | $14,454.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $1,905.46 | Professional | None | $851.14 | $1,348.96 | $1,905.46 |
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 $1,096.48 Median $1,122.02 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,122.02 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,202.26 Typical High $2,630.27 | Facility | None | $630.96 | $1,202.26 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,288.25 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $912.01 Typical High $1,479.11 | Professional | None | $123.03 | $912.01 | $1,479.11 |
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 $954.99 Median $1,148.15 Typical High $1,995.26 | Professional | None | $954.99 | $1,148.15 | $1,995.26 |
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 $467.74 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $190.55 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $707.95 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $141.25 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $660.69 | $870.96 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $660.69 Typical High $851.14 | Professional | 51 · Multiple procedures | $537.03 | $660.69 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $263.03 Typical High $338.84 | Professional | 80 · Assistant surgeon | $218.78 | $263.03 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $151.36 | $186.21 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $186.21 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $186.21 Typical High $239.88 | Professional | AS · PA/NP assist | $151.36 | $186.21 | $239.88 |
Where South Carolina sits
The same service costs 5.9 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· 42nd of 51
$1,148
OK $4,074UT $692
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.