How much rates vary
Facilitymedian $2,239 · 10th to 90th $339 to $12,023Professionalmedian $234 · 10th to 90th $132 to $832
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 $138.04 Median $10,964.78 Typical High $21,877.62 | Facility | None | $138.04 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $288.40 | Professional | None | $138.04 | $223.87 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $389.05 | Professional | None | $204.17 | $204.17 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $3,548.13 Typical High $15,135.61 | Facility | None | $1,174.90 | $3,548.13 | $15,135.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $208.93 Typical High $1,000.00 | Professional | None | $104.71 | $208.93 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $446.68 Typical High $1,584.89 | Facility | None | $165.96 | $446.68 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $338.84 Typical High $776.25 | Professional | None | $158.49 | $338.84 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $138.04 Median $338.84 Typical High $1,380.38 | Facility | None | $138.04 | $338.84 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $831.76 Typical High $912.01 | Professional | None | $213.80 | $831.76 | $912.01 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $380.19 | Professional | None | $199.53 | $288.40 | $380.19 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $977.24 | Professional | None | $120.23 | $218.78 | $977.24 |
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 $69.18 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $69.18 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $50.12 | Professional | 53 · Discontinued | $27.54 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $102.33 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.84 Typical High $37.15 | Professional | 55 · Aftercare only | $20.42 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $25.12 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $1,258.93 Typical High $1,380.38 | Professional | 50 · Both sides | $398.11 | $1,258.93 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $338.84 Typical High $457.09 | Professional | 51 · Multiple procedures | $134.90 | $338.84 | $457.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $165.96 Typical High $181.97 | Professional | 80 · Assistant surgeon | $61.66 | $165.96 | $181.97 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $117.49 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $42.66 | $117.49 | $128.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $117.49 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $117.49 | $128.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $117.49 Typical High $128.82 | Professional | AS · PA/NP assist | $42.66 | $117.49 | $128.82 |
Where South Carolina sits
The same service costs 3.2 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· 20th of 51
$288
OK $692TX $214
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.