How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,380 to $15,136Professionalmedian $813 · 10th to 90th $158 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 $851.14 Median $9,120.11 Typical High $22,908.68 | Facility | None | $851.14 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | None | $758.58 | $851.14 | $851.14 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,467.37 Median $6,918.31 Typical High $14,125.38 | Facility | None | $3,467.37 | $6,918.31 | $14,125.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,380.38 | Professional | None | $660.69 | $954.99 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,548.13 Typical High $4,897.79 | Facility | None | $602.56 | $3,548.13 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $1,548.82 | Professional | None | $831.76 | $851.14 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $851.14 Typical High $6,165.95 | Facility | None | $676.08 | $851.14 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,258.93 | Professional | None | $870.96 | $1,000.00 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $691.83 Typical High $1,148.15 | Professional | None | $123.03 | $691.83 | $1,148.15 |
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 $724.44 Median $891.25 Typical High $1,548.82 | Professional | None | $724.44 | $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 $380.19 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $501.19 Typical High $691.83 | Professional | 51 · Multiple procedures | $478.63 | $501.19 | $691.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $194.98 | $199.53 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $141.25 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $134.90 | $141.25 | $194.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $141.25 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $141.25 | $194.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $141.25 Typical High $194.98 | Professional | AS · PA/NP assist | $134.90 | $141.25 | $194.98 |
Where South Carolina sits
The same service costs 6.8 times more in Oklahoma 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· 41st of 51
$871
OK $3,548TX $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.