How much rates vary
Facilitymedian $955 · 10th to 90th $347 to $3,162Professionalmedian $389 · 10th to 90th $117 to $631
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 $398.11 Median $524.81 Typical High $21,877.62 | Facility | None | $398.11 | $524.81 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $524.81 | Professional | None | $398.11 | $467.74 | $524.81 |
BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,202.26 Typical High $2,089.30 | Facility | None | $691.83 | $1,202.26 | $2,089.30 |
BCBS Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $467.74 | Professional | None | $288.40 | $346.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $457.09 Typical High $794.33 | Facility | None | $354.81 | $457.09 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $812.83 | Professional | None | $363.08 | $489.78 | $812.83 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $323.59 Typical High $707.95 | Facility | None | $208.93 | $323.59 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $676.08 | Professional | None | $346.74 | $549.54 | $676.08 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $363.08 Typical High $575.44 | Professional | None | $38.02 | $363.08 | $575.44 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,606.93 | Facility | None | $302.00 | $1,122.02 | $6,606.93 |
United Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $891.25 | Professional | None | $338.84 | $467.74 | $891.25 |
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 $199.53 Median $199.53 Typical High $263.03 | Professional | 52 · Reduced service | $199.53 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | 53 · Discontinued | $79.43 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $389.05 | Professional | 54 · Surgery only | $302.00 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $77.62 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $302.00 Typical High $346.74 | Professional | 51 · Multiple procedures | $173.78 | $302.00 | $346.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $120.23 Typical High $138.04 | Professional | 80 · Assistant surgeon | $69.18 | $120.23 | $138.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $85.11 Typical High $95.50 | Professional | 81 · Minimal assistant surgeon | $47.86 | $85.11 | $95.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $85.11 Typical High $95.50 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $85.11 | $95.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $85.11 Typical High $95.50 | Professional | AS · PA/NP assist | $47.86 | $85.11 | $95.50 |
Where South Carolina sits
The same service costs 5.1 times more in Alaska 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· 46th of 51
$417
AK $1,514TX $295
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.