How much rates vary
Facilitymedian $3,467 · 10th to 90th $977 to $17,783Professionalmedian $759 · 10th to 90th $98 to $1,230
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 $1,000.00 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,000.00 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | None | $812.83 | $1,000.00 | $1,000.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,047.13 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,412.54 | Professional | None | $707.95 | $870.96 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $4,677.35 | Facility | None | $630.96 | $2,951.21 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,659.59 | Professional | None | $812.83 | $851.14 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,000.00 Typical High $2,344.23 | Facility | None | $758.58 | $1,000.00 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,174.90 | Professional | None | $831.76 | $954.99 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $645.65 Typical High $1,174.90 | Professional | None | $87.10 | $645.65 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,584.89 | Professional | None | $741.31 | $933.25 | $1,584.89 |
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 $407.38 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $575.44 | $707.95 | $707.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,412.54 Typical High $2,238.72 | Professional | 50 · Both sides | $1,412.54 | $1,412.54 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $478.63 Typical High $741.31 | Professional | 51 · Multiple procedures | $478.63 | $478.63 | $741.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $190.55 Typical High $295.12 | Professional | 80 · Assistant surgeon | $190.55 | $190.55 | $295.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $131.83 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $131.83 | $131.83 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $131.83 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $131.83 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $131.83 Typical High $208.93 | Professional | AS · PA/NP assist | $131.83 | $131.83 | $208.93 |
Where South Carolina sits
The same service costs 7.4 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· 44th of 51
$851
OK $3,890TX $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.