How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,000 to $13,183Professionalmedian $550 · 10th to 90th $105 to $794
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 $676.08 Median $10,000.00 Typical High $20,417.38 | Facility | None | $676.08 | $10,000.00 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $851.14 | Professional | None | $575.44 | $676.08 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $3,981.07 Typical High $12,589.25 | Facility | None | $1,202.26 | $3,981.07 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $776.25 | Professional | None | $537.03 | $630.96 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $2,951.21 | Facility | None | $630.96 | $1,819.70 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,047.13 | Professional | None | $645.65 | $645.65 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $2,398.83 | Facility | None | $645.65 | $1,047.13 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $794.33 | Professional | None | $645.65 | $691.83 | $794.33 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $436.52 Typical High $741.31 | Professional | None | $79.43 | $436.52 | $741.31 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $977.24 | Professional | None | $478.63 | $602.56 | $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 $288.40 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $288.40 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $114.82 | $134.90 | $134.90 |
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 $87.10 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $57.54 | $67.61 | $67.61 |
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 $1,202.26 Typical High $1,584.89 | Professional | 50 · Both sides | $977.24 | $1,202.26 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $398.11 Typical High $524.81 | Professional | 51 · Multiple procedures | $323.59 | $398.11 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $158.49 Typical High $208.93 | Professional | 80 · Assistant surgeon | $128.82 | $158.49 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $112.20 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $91.20 | $112.20 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $112.20 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $112.20 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $112.20 Typical High $147.91 | Professional | AS · PA/NP assist | $91.20 | $112.20 | $147.91 |
Where South Carolina sits
The same service costs 3.9 times more in Wisconsin than in Montana. 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
WI $7,471MT $1,932
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.