How much rates vary
Facilitymedian $1,950 · 10th to 90th $759 to $10,715Professionalmedian $468 · 10th to 90th $69 to $692
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 $524.81 Median $10,000.00 Typical High $21,877.62 | Facility | None | $524.81 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $524.81 | Professional | None | $398.11 | $524.81 | $524.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,019.95 Typical High $9,549.93 | Facility | None | $851.14 | $3,019.95 | $9,549.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $741.31 | Professional | None | $363.08 | $512.86 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,630.27 | Facility | None | $602.56 | $1,862.09 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $891.25 | Professional | None | $457.09 | $467.74 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $1,698.24 | Facility | None | $446.68 | $741.31 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $616.60 | Professional | None | $436.52 | $537.03 | $616.60 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $426.58 Typical High $676.08 | Professional | None | $56.23 | $426.58 | $676.08 |
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 $389.05 Median $478.63 Typical High $831.76 | Professional | None | $389.05 | $478.63 | $831.76 |
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 $199.53 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $199.53 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $79.43 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $302.00 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $39.81 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $281.84 | $371.54 | $371.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $812.83 Typical High $1,122.02 | Professional | 50 · Both sides | $660.69 | $812.83 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $269.15 Typical High $380.19 | Professional | 51 · Multiple procedures | $218.78 | $269.15 | $380.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $107.15 Typical High $144.54 | Professional | 80 · Assistant surgeon | $89.13 | $107.15 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $75.86 Typical High $102.33 | Professional | 81 · Minimal assistant surgeon | $61.66 | $75.86 | $102.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $75.86 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $75.86 | $102.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $75.86 Typical High $102.33 | Professional | AS · PA/NP assist | $61.66 | $75.86 | $102.33 |
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
$525
OK $1,862UT $309
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.