How much rates vary
Facilitymedian $6,918 · 10th to 90th $2,692 to $20,893Professionalmedian $832 · 10th to 90th $102 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 $977.24 Median $10,000.00 Typical High $21,877.62 | Facility | None | $977.24 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $977.24 | Professional | None | $831.76 | $977.24 | $977.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,630.78 Median $7,079.46 Typical High $19,952.62 | Facility | None | $3,630.78 | $7,079.46 | $19,952.62 |
BCBS South Carolina Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,148.15 | Professional | None | $812.83 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $7,244.36 | Facility | None | $602.56 | $4,265.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $1,548.82 | Professional | None | $891.25 | $912.01 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $1,096.48 Typical High $3,090.30 | Facility | None | $660.69 | $1,096.48 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,148.15 | Professional | None | $912.01 | $1,000.00 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $660.69 Typical High $1,148.15 | Professional | None | $79.43 | $660.69 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,445.44 | Professional | None | $707.95 | $870.96 | $1,445.44 |
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 $416.87 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $691.83 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $524.81 Typical High $758.58 | Professional | 51 · Multiple procedures | $446.68 | $524.81 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $208.93 Typical High $309.03 | Professional | 80 · Assistant surgeon | $181.97 | $208.93 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $147.91 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $125.89 | $147.91 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $147.91 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $147.91 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $213.80 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $213.80 |
Where South Carolina sits
The same service costs 5.1 times more in Oklahoma than in Kentucky. 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.
Physician feeFacility fee
OK $11,738KY $2,311
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.