How much rates vary
Facilitymedian $1,318 · 10th to 90th $617 to $5,888Professionalmedian $186 · 10th to 90th $117 to $309
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 $199.53 Median $5,888.44 Typical High $21,877.62 | Facility | None | $199.53 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | None | $177.83 | $199.53 | $199.53 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,288.25 Typical High $5,128.61 | Facility | None | $676.08 | $1,288.25 | $5,128.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $223.87 | Professional | None | $154.88 | $186.21 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,412.54 Typical High $2,238.72 | Facility | None | $602.56 | $1,412.54 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $363.08 | Professional | None | $181.97 | $194.98 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $190.55 Median $512.86 Typical High $691.83 | Facility | None | $190.55 | $512.86 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $245.47 | Professional | None | $208.93 | $218.78 | $245.47 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $309.03 | Professional | None | $104.71 | $181.97 | $309.03 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $354.81 | Professional | None | $165.96 | $204.17 | $354.81 |
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 $89.13 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $35.48 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $141.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $104.71 Median $112.20 Typical High $162.18 | Professional | 51 · Multiple procedures | $104.71 | $112.20 | $162.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $44.67 Typical High $64.57 | Professional | 80 · Assistant surgeon | $41.69 | $44.67 | $64.57 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $29.51 Median $31.62 Typical High $45.71 | Professional | 81 · Minimal assistant surgeon | $29.51 | $31.62 | $45.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $29.51 Median $31.62 Typical High $45.71 | Professional | 82 · Assistant surgeon, no resident | $29.51 | $31.62 | $45.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $31.62 Typical High $45.71 | Professional | AS · PA/NP assist | $29.51 | $31.62 | $45.71 |
Where South Carolina sits
The same service costs 8.7 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· 45th of 51
$204
OK $1,349UT $155
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.