How much rates vary
Facilitymedian $1,995 · 10th to 90th $676 to $14,125Professionalmedian $398 · 10th to 90th $224 to $603
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 $407.38 Median $5,888.44 Typical High $21,877.62 | Facility | None | $407.38 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $14,125.38 | Facility | None | $691.83 | $1,778.28 | $14,125.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $758.58 | Professional | None | $316.23 | $467.74 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $3,162.28 | Facility | None | $630.96 | $1,905.46 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $741.31 | Professional | None | $389.05 | $416.87 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $1,862.09 Typical High $2,511.89 | Facility | None | $407.38 | $1,862.09 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $851.14 | Professional | None | $426.58 | $489.78 | $851.14 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $371.54 Typical High $588.84 | Professional | None | $66.07 | $371.54 | $588.84 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $758.58 | Professional | None | $346.74 | $436.52 | $758.58 |
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 $181.97 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $288.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $245.47 Typical High $426.58 | Professional | 51 · Multiple procedures | $223.87 | $245.47 | $426.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $97.72 Typical High $169.82 | Professional | 80 · Assistant surgeon | $91.20 | $97.72 | $169.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $63.10 Median $69.18 Typical High $120.23 | Professional | 81 · Minimal assistant surgeon | $63.10 | $69.18 | $120.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $63.10 Median $69.18 Typical High $120.23 | Professional | 82 · Assistant surgeon, no resident | $63.10 | $69.18 | $120.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $69.18 Typical High $120.23 | Professional | AS · PA/NP assist | $63.10 | $69.18 | $120.23 |
Where South Carolina sits
The same service costs 7.1 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· 40th of 51
$457
OK $1,950UT $275
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.