How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,202 to $12,303Professionalmedian $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 $10,964.78 Typical High $21,877.62 | Facility | None | $912.01 | $10,964.78 | $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 $1,548.82 Median $3,630.78 Typical High $7,943.28 | Facility | None | $1,548.82 | $3,630.78 | $7,943.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,318.26 | Professional | None | $630.96 | $912.01 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
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 $1,000.00 Typical High $2,290.87 | Facility | None | $630.96 | $1,000.00 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,122.02 | Professional | None | $758.58 | $954.99 | $1,122.02 |
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 $691.83 Median $831.76 Typical High $1,479.11 | Professional | None | $691.83 | $831.76 | $1,479.11 |
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 $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 50 · Both sides Typical Low $1,122.02 Median $1,412.54 Typical High $1,995.26 | Professional | 50 · Both sides | $1,122.02 | $1,412.54 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $478.63 Typical High $630.96 | Professional | 51 · Multiple procedures | $371.54 | $478.63 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $190.55 Typical High $251.19 | Professional | 80 · Assistant surgeon | $151.36 | $190.55 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $131.83 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $104.71 | $131.83 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $131.83 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $131.83 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $131.83 Typical High $177.83 | Professional | AS · PA/NP assist | $104.71 | $131.83 | $177.83 |
Where South Carolina sits
The same service costs 6.3 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· 38th of 51
$871
OK $3,311UT $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.