How much rates vary
Facilitymedian $2,089 · 10th to 90th $661 to $17,378Professionalmedian $871 · 10th to 90th $69 to $1,349
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 Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,621.81 | Professional | None | $724.44 | $1,071.52 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $1,778.28 | Professional | None | $912.01 | $933.25 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,238.72 | Facility | None | $707.95 | $1,000.00 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $933.25 | $1,096.48 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $776.25 Typical High $1,318.26 | Professional | None | $66.07 | $776.25 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,019.95 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,019.95 | $18,197.01 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,698.24 | Professional | None | $794.33 | $1,000.00 | $1,698.24 |
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 $398.11 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $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 $602.56 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $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 $562.34 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $707.95 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $549.54 Typical High $831.76 | Professional | 51 · Multiple procedures | $478.63 | $549.54 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $218.78 Typical High $331.13 | Professional | 80 · Assistant surgeon | $190.55 | $218.78 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $151.36 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $134.90 | $151.36 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $151.36 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $151.36 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $151.36 Typical High $234.42 | Professional | AS · PA/NP assist | $134.90 | $151.36 | $234.42 |
Where South Carolina sits
The same service costs 6.2 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
$891
OK $3,631UT $589
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.