How much rates vary
Facilitymedian $2,138 · 10th to 90th $813 to $15,136Professionalmedian $776 · 10th to 90th $102 to $1,148
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 $912.01 Median $10,000.00 Typical High $21,877.62 | Facility | None | $912.01 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $912.01 | Professional | None | $691.83 | $912.01 | $912.01 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $14,454.40 | Facility | None | $851.14 | $3,548.13 | $14,454.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,380.38 | Professional | None | $630.96 | $954.99 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,630.27 | Facility | None | $602.56 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,548.82 | Professional | None | $776.25 | $794.33 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $1,995.26 | Facility | None | $630.96 | $912.01 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,148.15 | Professional | None | $776.25 | $812.83 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $691.83 Typical High $1,122.02 | Professional | None | $81.28 | $691.83 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,479.11 | Professional | None | $676.08 | $831.76 | $1,479.11 |
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 $346.74 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $645.65 | $645.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $467.74 Typical High $630.96 | Professional | 51 · Multiple procedures | $380.19 | $467.74 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $186.21 Typical High $251.19 | Professional | 80 · Assistant surgeon | $154.88 | $186.21 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $128.82 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $107.15 | $128.82 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $128.82 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $128.82 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $177.83 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $177.83 |
Where South Carolina sits
The same service costs 7.2 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· 40th of 51
$871
OK $3,802UT $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.