How much rates vary
Facilitymedian $2,138 · 10th to 90th $933 to $14,125Professionalmedian $417 · 10th to 90th $66 to $661
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 $478.63 Median $10,000.00 Typical High $21,877.62 | Facility | None | $478.63 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | None | $426.58 | $478.63 | $478.63 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,365.16 Typical High $14,125.38 | Facility | None | $1,047.13 | $4,365.16 | $14,125.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $831.76 | Professional | None | $363.08 | $501.19 | $831.76 |
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 $426.58 Median $446.68 Typical High $851.14 | Professional | None | $426.58 | $446.68 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $1,862.09 Typical High $2,511.89 | Facility | None | $457.09 | $1,862.09 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $645.65 | Professional | None | $489.78 | $524.81 | $645.65 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $338.84 Typical High $630.96 | Professional | None | $60.26 | $338.84 | $630.96 |
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 $489.78 Typical High $851.14 | Professional | None | $389.05 | $489.78 | $851.14 |
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 $213.80 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $213.80 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $85.11 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $42.66 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $295.12 | $331.13 | $331.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $263.03 Typical High $380.19 | Professional | 51 · Multiple procedures | $251.19 | $263.03 | $380.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $104.71 Typical High $154.88 | Professional | 80 · Assistant surgeon | $100.00 | $104.71 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $72.44 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $70.79 | $72.44 | $107.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $72.44 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $72.44 | $107.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $72.44 Typical High $107.15 | Professional | AS · PA/NP assist | $70.79 | $72.44 | $107.15 |
Where South Carolina sits
The same service costs 10.2 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· 44th of 51
$479
OK $2,951UT $288
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.