How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $9,772Professionalmedian $759 · 10th to 90th $115 to $1,072
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 $977.24 Median $10,000.00 Typical High $21,877.62 | Facility | None | $977.24 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $977.24 | Professional | None | $912.01 | $977.24 | $977.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $812.83 Median $1,778.28 Typical High $4,786.30 | Facility | None | $812.83 | $1,778.28 | $4,786.30 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $912.01 | Professional | None | $660.69 | $758.58 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,548.82 Typical High $3,090.30 | Facility | None | $602.56 | $1,548.82 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,412.54 | Professional | None | $794.33 | $933.25 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,047.13 Typical High $2,137.96 | Facility | None | $812.83 | $1,047.13 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $891.25 | $1,047.13 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $575.44 Typical High $1,071.52 | Professional | None | $102.33 | $575.44 | $1,071.52 |
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 $691.83 Median $851.14 Typical High $1,513.56 | Professional | None | $691.83 | $851.14 | $1,513.56 |
12 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 $478.63 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $190.55 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $724.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $691.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,584.89 Typical High $1,659.59 | Professional | 50 · Both sides | $1,584.89 | $1,584.89 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | 51 · Multiple procedures | $524.81 | $524.81 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | 80 · Assistant surgeon | $208.93 | $208.93 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $147.91 | $147.91 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $147.91 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | AS · PA/NP assist | $147.91 | $147.91 | $154.88 |
Where South Carolina sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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.
Physician feeFacility fee
OK $7,181MS $1,948
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.