How much rates vary
Facilitymedian $2,042 · 10th to 90th $501 to $11,220Professionalmedian $457 · 10th to 90th $316 to $646
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 $426.58 Median $5,623.41 Typical High $21,877.62 | Facility | None | $426.58 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $426.58 | Professional | None | $346.74 | $426.58 | $426.58 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $2,344.23 Typical High $10,471.29 | Facility | None | $512.86 | $2,344.23 | $10,471.29 |
BCBS South Carolina Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $691.83 | Professional | None | $302.00 | $467.74 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $4,168.69 | Facility | None | $457.09 | $1,479.11 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $776.25 | Professional | None | $407.38 | $416.87 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $1,348.96 | Facility | None | $398.11 | $501.19 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $562.34 | Professional | None | $407.38 | $457.09 | $562.34 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $645.65 | Professional | None | $331.13 | $478.63 | $645.65 |
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 $338.84 Median $446.68 Typical High $741.31 | Professional | None | $338.84 | $446.68 | $741.31 |
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 $173.78 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $42.66 | $42.66 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $691.83 Typical High $1,000.00 | Professional | 50 · Both sides | $645.65 | $691.83 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $234.42 Typical High $316.23 | Professional | 51 · Multiple procedures | $213.80 | $234.42 | $316.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $91.20 Typical High $125.89 | Professional | 80 · Assistant surgeon | $85.11 | $91.20 | $125.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $60.26 Median $63.10 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $60.26 | $63.10 | $87.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $60.26 Median $63.10 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $60.26 | $63.10 | $87.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $63.10 Typical High $87.10 | Professional | AS · PA/NP assist | $60.26 | $63.10 | $87.10 |
Where South Carolina sits
The same service costs 7.8 times more in Oklahoma than in New York. 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· 31st of 51
$525
OK $2,630NY $339
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.