How much rates vary
Facilitymedian $2,138 · 10th to 90th $661 to $17,378Professionalmedian $661 · 10th to 90th $178 to $1,259
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 $933.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $933.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $933.25 | Professional | None | $794.33 | $933.25 | $933.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,348.96 | Professional | None | $660.69 | $707.95 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,445.44 | Professional | None | $794.33 | $870.96 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $2,238.72 | Facility | None | $676.08 | $933.25 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,096.48 | Professional | None | $812.83 | $891.25 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $524.81 Typical High $1,148.15 | Professional | None | $162.18 | $524.81 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,090.30 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,621.81 | Professional | None | $758.58 | $954.99 | $1,621.81 |
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 $398.11 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $660.69 | $660.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $478.63 Typical High $724.44 | Professional | 51 · Multiple procedures | $398.11 | $478.63 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $288.40 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $134.90 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $112.20 | $134.90 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $134.90 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $134.90 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $134.90 Typical High $204.17 | Professional | AS · PA/NP assist | $112.20 | $134.90 | $204.17 |
Where South Carolina sits
The same service costs 8.5 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· 48th of 51
$692
OK $3,162TX $372
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.