How much rates vary
Facilitymedian $2,138 · 10th to 90th $933 to $15,136Professionalmedian $1,175 · 10th to 90th $631 to $1,820
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 $707.95 Median $10,964.78 Typical High $21,877.62 | Facility | None | $707.95 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $707.95 | Professional | None | $537.03 | $707.95 | $707.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,677.35 Typical High $14,454.40 | Facility | None | $1,047.13 | $4,677.35 | $14,454.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,202.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $2,884.03 | Facility | None | $630.96 | $1,862.09 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $1,202.26 | Professional | None | $616.60 | $645.65 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $2,089.30 | Facility | None | $707.95 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,071.52 | Professional | None | $630.96 | $741.31 | $1,071.52 |
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 $1,318.26 Typical High $2,691.53 | Professional | None | $676.08 | $1,318.26 | $2,691.53 |
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 $269.15 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $407.38 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $81.28 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $380.19 | $501.19 | $501.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $389.05 Typical High $537.03 | Professional | 51 · Multiple procedures | $363.08 | $389.05 | $537.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $158.49 Typical High $213.80 | Professional | 80 · Assistant surgeon | $144.54 | $158.49 | $213.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $109.65 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $100.00 | $109.65 | $151.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $109.65 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $109.65 | $151.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $109.65 Typical High $151.36 | Professional | AS · PA/NP assist | $100.00 | $109.65 | $151.36 |
Where South Carolina sits
The same service costs 7.4 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· 14th of 51
$1,380
OK $3,802NY $513
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.