How much rates vary
Facilitymedian $3,548 · 10th to 90th $933 to $14,125Professionalmedian $513 · 10th to 90th $316 to $741
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 $549.54 Median $10,964.78 Typical High $21,877.62 | Facility | None | $549.54 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $549.54 | Professional | None | $416.87 | $549.54 | $549.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,365.16 Typical High $13,182.57 | Facility | None | $1,047.13 | $4,365.16 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $794.33 | Professional | None | $380.19 | $524.81 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $5,128.61 | Facility | None | $630.96 | $2,951.21 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $933.25 | Professional | None | $478.63 | $489.78 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $2,089.30 | Facility | None | $478.63 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $724.44 | Professional | None | $436.52 | $575.44 | $724.44 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $478.63 Typical High $724.44 | Professional | None | $66.07 | $478.63 | $724.44 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $891.25 | Professional | None | $407.38 | $501.19 | $891.25 |
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 $208.93 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $208.93 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $63.10 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $41.69 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $295.12 | $389.05 | $389.05 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $851.14 Typical High $1,202.26 | Professional | 50 · Both sides | $660.69 | $851.14 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $288.40 Typical High $380.19 | Professional | 51 · Multiple procedures | $218.78 | $288.40 | $380.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $114.82 Typical High $151.36 | Professional | 80 · Assistant surgeon | $89.13 | $114.82 | $151.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $79.43 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $61.66 | $79.43 | $107.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $79.43 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $79.43 | $107.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $79.43 Typical High $107.15 | Professional | AS · PA/NP assist | $61.66 | $79.43 | $107.15 |
Where South Carolina sits
The same service costs 9.8 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· 42nd of 51
$550
OK $3,236UT $331
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.