How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,122 to $19,055Professionalmedian $1,175 · 10th to 90th $151 to $1,698
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 $1,479.11 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,479.11 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,479.11 | $1,479.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $5,623.41 Typical High $19,054.61 | Facility | None | $1,202.26 | $5,623.41 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,258.93 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,388.44 Typical High $5,623.41 | Facility | None | $630.96 | $3,388.44 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,479.11 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $3,548.13 | Facility | None | $912.01 | $1,380.38 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,548.82 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $912.01 Typical High $1,548.82 | Professional | None | $120.23 | $912.01 | $1,548.82 |
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 $1,047.13 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,348.96 | $2,187.76 |
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 $630.96 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $630.96 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $251.19 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $933.25 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $870.96 | $1,023.29 | $1,023.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $870.96 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $645.65 | $870.96 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $346.74 Typical High $457.09 | Professional | 80 · Assistant surgeon | $257.04 | $346.74 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $245.47 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $181.97 | $245.47 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $245.47 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $245.47 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $245.47 Typical High $316.23 | Professional | AS · PA/NP assist | $181.97 | $245.47 | $316.23 |
Where South Carolina sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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
CO $14,661HI $3,664
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.