How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,514 to $17,783Professionalmedian $537 · 10th to 90th $98 to $776
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 $660.69 Median $10,964.78 Typical High $21,877.62 | Facility | None | $660.69 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $660.69 | Professional | None | $575.44 | $660.69 | $660.69 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $5,754.40 Typical High $17,378.01 | Facility | None | $1,905.46 | $5,754.40 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $776.25 | Professional | None | $512.86 | $630.96 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $4,677.35 | Facility | None | $630.96 | $2,951.21 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,047.13 | Professional | None | $616.60 | $616.60 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $2,344.23 Typical High $3,162.28 | Facility | None | $630.96 | $2,344.23 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $933.25 | Professional | None | $645.65 | $758.58 | $933.25 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $724.44 | Professional | None | $79.43 | $416.87 | $724.44 |
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 $478.63 Median $588.84 Typical High $977.24 | Professional | None | $478.63 | $588.84 | $977.24 |
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 $281.84 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $426.58 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $85.11 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $398.11 | $467.74 | $467.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,174.90 Typical High $1,548.82 | Professional | 50 · Both sides | $977.24 | $1,174.90 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $389.05 Typical High $512.86 | Professional | 51 · Multiple procedures | $323.59 | $389.05 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $154.88 Typical High $208.93 | Professional | 80 · Assistant surgeon | $128.82 | $154.88 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $109.65 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $91.20 | $109.65 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $109.65 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $109.65 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $109.65 Typical High $144.54 | Professional | AS · PA/NP assist | $91.20 | $109.65 | $144.54 |
Where South Carolina sits
The same service costs 5.4 times more in Oklahoma 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
OK $9,993KY $1,838
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.