How much rates vary
Facilitymedian $871 · 10th to 90th $479 to $4,266Professionalmedian $204 · 10th to 90th $135 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 $229.09 Median $5,623.41 Typical High $21,877.62 | Facility | None | $229.09 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | None | $190.55 | $229.09 | $229.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $3,162.28 | Facility | None | $512.86 | $870.96 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $218.78 | Professional | None | $123.03 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,174.90 | Facility | None | $457.09 | $741.31 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $398.11 | Professional | None | $199.53 | $223.87 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $478.63 Typical High $512.86 | Facility | None | $229.09 | $478.63 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $295.12 | Professional | None | $190.55 | $239.88 | $295.12 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $302.00 | Professional | None | $134.90 | $208.93 | $302.00 |
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 $177.83 Median $229.09 Typical High $380.19 | Professional | None | $177.83 | $229.09 | $380.19 |
12 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 $95.50 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $38.02 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $28.84 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.05 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $134.90 | $162.18 | $162.18 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $363.08 Typical High $512.86 | Professional | 50 · Both sides | $295.12 | $363.08 | $512.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $123.03 Typical High $169.82 | Professional | 51 · Multiple procedures | $100.00 | $123.03 | $169.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $47.86 Typical High $67.61 | Professional | 80 · Assistant surgeon | $39.81 | $47.86 | $67.61 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $27.54 Median $33.88 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $27.54 | $33.88 | $47.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $27.54 Median $33.88 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $27.54 | $33.88 | $47.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $33.88 Typical High $47.86 | Professional | AS · PA/NP assist | $27.54 | $33.88 | $47.86 |
Where South Carolina sits
The same service costs 8.9 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
$229
OK $1,413UT $158
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.