How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,072 to $19,055Professionalmedian $776 · 10th to 90th $105 to $1,202
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 $933.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $933.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,000.00 | Professional | None | $794.33 | $933.25 | $1,000.00 |
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 $724.44 Median $1,174.90 Typical High $1,513.56 | Professional | None | $724.44 | $1,174.90 | $1,513.56 |
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 $1,000.00 Median $1,023.29 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,023.29 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,047.13 Typical High $3,981.07 | Facility | None | $851.14 | $1,047.13 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,318.26 | Professional | None | $933.25 | $1,096.48 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $616.60 Typical High $1,023.29 | Professional | None | $79.43 | $616.60 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,677.35 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,677.35 | $24,547.09 |
United Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,445.44 | Professional | None | $676.08 | $851.14 | $1,445.44 |
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 $398.11 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $602.56 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $562.34 | $660.69 | $660.69 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $2,238.72 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $588.84 Typical High $741.31 | Professional | 51 · Multiple procedures | $489.78 | $588.84 | $741.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $234.42 Typical High $295.12 | Professional | 80 · Assistant surgeon | $199.53 | $234.42 | $295.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $165.96 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $138.04 | $165.96 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $165.96 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $165.96 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $208.93 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $208.93 |
Where South Carolina sits
The same service costs 5.9 times more in Colorado than in West Virginia. 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 $14,031WV $2,390
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.