How much rates vary
Facilitymedian $6,918 · 10th to 90th $2,399 to $20,893Professionalmedian $1,047 · 10th to 90th $135 to $1,698
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 $1,230.27 Median $16,595.87 Typical High $38,904.51 | Facility | None | $1,230.27 | $16,595.87 | $38,904.51 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,715.35 Median $7,079.46 Typical High $19,498.45 | Facility | None | $3,715.35 | $7,079.46 | $19,498.45 |
BCBS South Carolina Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,398.83 | Professional | None | $954.99 | $1,445.44 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,495.41 Typical High $7,762.47 | Facility | None | $602.56 | $5,495.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,230.27 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $6,165.95 | Facility | None | $1,023.29 | $1,659.59 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,479.11 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $870.96 Typical High $1,659.59 | Professional | None | $128.82 | $870.96 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,165.95 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,165.95 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,348.96 | $2,290.87 |
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 $549.54 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $870.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $776.25 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $691.83 | $776.25 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $309.03 Typical High $398.11 | Professional | 80 · Assistant surgeon | $281.84 | $309.03 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $218.78 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $194.98 | $218.78 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $218.78 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $218.78 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $218.78 Typical High $281.84 | Professional | AS · PA/NP assist | $194.98 | $218.78 | $281.84 |
Where South Carolina sits
The same service costs 8.7 times more in Oklahoma than in Texas. 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· 45th of 51
$1,175
OK $6,166TX $708
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.