How much rates vary
Facilitymedian $1,778 · 10th to 90th $661 to $9,550Professionalmedian $457 · 10th to 90th $102 to $708
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 $501.19 Median $5,888.44 Typical High $21,877.62 | Facility | None | $501.19 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | None | $457.09 | $501.19 | $501.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $8,128.31 | Facility | None | $691.83 | $1,737.80 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $691.83 | Professional | None | $389.05 | $436.52 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,691.53 | Facility | None | $602.56 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $912.01 | Professional | None | $457.09 | $478.63 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $676.08 Typical High $1,479.11 | Facility | None | $489.78 | $676.08 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $616.60 | Professional | None | $446.68 | $549.54 | $616.60 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $416.87 Typical High $691.83 | Professional | None | $81.28 | $416.87 | $691.83 |
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 $416.87 Median $512.86 Typical High $912.01 | Professional | None | $416.87 | $512.86 | $912.01 |
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 $223.87 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $67.61 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $316.23 | $354.81 | $354.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $275.42 Typical High $407.38 | Professional | 51 · Multiple procedures | $223.87 | $275.42 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $109.65 Typical High $162.18 | Professional | 80 · Assistant surgeon | $89.13 | $109.65 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $63.10 Median $75.86 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $63.10 | $75.86 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $63.10 Median $75.86 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $63.10 | $75.86 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $75.86 Typical High $114.82 | Professional | AS · PA/NP assist | $63.10 | $75.86 | $114.82 |
Where South Carolina sits
The same service costs 8.9 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· 46th of 51
$490
OK $2,754UT $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.