How much rates vary
Facilitymedian $1,905 · 10th to 90th $933 to $10,715Professionalmedian $741 · 10th to 90th $102 to $1,122
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 $891.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $891.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $891.25 | Professional | None | $676.08 | $891.25 | $891.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $3,090.30 Typical High $9,549.93 | Facility | None | $1,023.29 | $3,090.30 | $9,549.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,258.93 | Professional | None | $602.56 | $891.25 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,905.46 | Facility | None | $602.56 | $1,122.02 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,479.11 | Professional | None | $776.25 | $776.25 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $1,621.81 | Facility | None | $758.58 | $1,288.25 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,023.29 | Professional | None | $724.44 | $870.96 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $660.69 Typical High $1,096.48 | Professional | None | $81.28 | $660.69 | $1,096.48 |
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 $645.65 Median $794.33 Typical High $1,412.54 | Professional | None | $645.65 | $794.33 | $1,412.54 |
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 $338.84 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $338.84 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $134.90 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $501.19 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $67.61 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $467.74 | $616.60 | $616.60 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,348.96 Typical High $1,819.70 | Professional | 50 · Both sides | $1,096.48 | $1,348.96 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $446.68 Typical High $616.60 | Professional | 51 · Multiple procedures | $363.08 | $446.68 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $173.78 Typical High $245.47 | Professional | 80 · Assistant surgeon | $144.54 | $173.78 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $123.03 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $102.33 | $123.03 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $123.03 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $123.03 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $169.82 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $169.82 |
Where South Carolina sits
The same service costs 6.0 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
$832
OK $2,884UT $479
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.