How much rates vary
Facilitymedian $912 · 10th to 90th $417 to $8,710Professionalmedian $437 · 10th to 90th $102 to $692
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 $524.81 Median $5,888.44 Typical High $21,877.62 | Facility | None | $524.81 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | None | $446.68 | $524.81 | $524.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $794.33 | Professional | None | $398.11 | $501.19 | $794.33 |
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 $436.52 Median $489.78 Typical High $812.83 | Professional | None | $436.52 | $489.78 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $1,258.93 | Facility | None | $380.19 | $524.81 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $616.60 | Professional | None | $457.09 | $489.78 | $616.60 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $380.19 Typical High $676.08 | Professional | None | $81.28 | $380.19 | $676.08 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $912.01 | Professional | None | $416.87 | $537.03 | $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 $218.78 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $218.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $66.07 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $309.03 | $371.54 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $263.03 Typical High $407.38 | Professional | 51 · Multiple procedures | $229.09 | $263.03 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $104.71 Typical High $165.96 | Professional | 80 · Assistant surgeon | $91.20 | $104.71 | $165.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $74.13 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $64.57 | $74.13 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $74.13 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $74.13 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $74.13 Typical High $114.82 | Professional | AS · PA/NP assist | $64.57 | $74.13 | $114.82 |
Where South Carolina sits
The same service costs 7.2 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· 47th of 51
$437
OK $2,042UT $282
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.