How much rates vary
Facilitymedian $2,239 · 10th to 90th $933 to $10,000Professionalmedian $263 · 10th to 90th $200 to $427
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 $251.19 Median $10,964.78 Typical High $21,877.62 | Facility | None | $251.19 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $281.84 | Professional | None | $218.78 | $251.19 | $281.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $2,630.27 Typical High $8,128.31 | Facility | None | $1,202.26 | $2,630.27 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $389.05 | Professional | None | $190.55 | $251.19 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $3,162.28 | Facility | None | $602.56 | $1,905.46 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $416.87 | Professional | None | $208.93 | $245.47 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $239.88 Median $891.25 Typical High $1,380.38 | Facility | None | $239.88 | $891.25 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $501.19 | Professional | None | $251.19 | $263.03 | $501.19 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $436.52 | Professional | None | $199.53 | $295.12 | $436.52 |
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 $204.17 Median $263.03 Typical High $467.74 | Professional | None | $204.17 | $263.03 | $467.74 |
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 $109.65 Median $125.89 Typical High $141.25 | Professional | 52 · Reduced service | $109.65 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $43.65 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $190.55 Typical High $213.80 | Professional | 54 · Surgery only | $162.18 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $32.36 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.12 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.88 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $177.83 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $151.36 | $177.83 | $199.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $134.90 Typical High $245.47 | Professional | 51 · Multiple procedures | $125.89 | $134.90 | $245.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $52.48 Typical High $100.00 | Professional | 80 · Assistant surgeon | $50.12 | $52.48 | $100.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $36.31 Typical High $69.18 | Professional | 81 · Minimal assistant surgeon | $35.48 | $36.31 | $69.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $36.31 Typical High $69.18 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $36.31 | $69.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $36.31 Typical High $69.18 | Professional | AS · PA/NP assist | $35.48 | $36.31 | $69.18 |
Where South Carolina sits
The same service costs 4.6 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· 34th of 51
$295
OK $1,047UT $229
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.