How much rates vary
Facilitymedian $4,169 · 10th to 90th $813 to $15,488Professionalmedian $1,023 · 10th to 90th $158 to $1,660
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 $1,202.26 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,202.26 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,318.26 | Professional | None | $912.01 | $1,202.26 | $1,318.26 |
Ambetter Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $4,897.79 Typical High $14,791.08 | Facility | None | $851.14 | $4,897.79 | $14,791.08 |
BCBS South Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,412.54 Typical High $2,041.74 | Professional | None | $812.83 | $1,412.54 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $7,585.78 | Facility | None | $602.56 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,122.02 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $2,570.40 | Facility | None | $630.96 | $1,000.00 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,258.93 | $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 $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,949.84 | Professional | None | $933.25 | $1,148.15 | $1,949.84 |
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 $457.09 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $457.09 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $186.21 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $691.83 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $91.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $645.65 | $851.14 | $851.14 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $645.65 Typical High $831.76 | Professional | 51 · Multiple procedures | $524.81 | $645.65 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $257.04 Typical High $331.13 | Professional | 80 · Assistant surgeon | $213.80 | $257.04 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $181.97 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $147.91 | $181.97 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $181.97 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $181.97 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $234.42 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $234.42 |
Where South Carolina sits
The same service costs 6.3 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
$1,122
OK $4,169UT $661
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.