How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,479 to $17,783Professionalmedian $759 · 10th to 90th $107 to $1,380
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 $912.01 Median $12,022.64 Typical High $21,877.62 | Facility | None | $912.01 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $912.01 | Professional | None | $776.25 | $912.01 | $912.01 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,698.24 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $676.08 Median $1,380.38 Typical High $1,479.11 | Professional | None | $676.08 | $1,380.38 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $4,677.35 | Facility | None | $630.96 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,412.54 | Professional | None | $870.96 | $870.96 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $3,162.28 Typical High $3,715.35 | Facility | None | $912.01 | $3,162.28 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,621.81 | Professional | None | $912.01 | $1,047.13 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $954.99 | Professional | None | $79.43 | $562.34 | $954.99 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,348.96 | Professional | None | $660.69 | $831.76 | $1,348.96 |
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 $389.05 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $389.05 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $588.84 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $117.49 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $77.62 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $549.54 | $645.65 | $645.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,737.80 Typical High $2,454.71 | Professional | 50 · Both sides | $1,412.54 | $1,737.80 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $575.44 Typical High $812.83 | Professional | 51 · Multiple procedures | $478.63 | $575.44 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $323.59 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $162.18 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $131.83 | $162.18 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $162.18 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $162.18 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $162.18 Typical High $229.09 | Professional | AS · PA/NP assist | $131.83 | $162.18 | $229.09 |
Where South Carolina sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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
AK $10,315KY $2,095
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.