How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,445 to $19,055Professionalmedian $977 · 10th to 90th $158 to $1,585
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 $1,230.27 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,230.27 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,230.27 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $5,623.41 Typical High $18,620.87 | Facility | None | $1,698.24 | $5,623.41 | $18,620.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $1,905.46 | Professional | None | $933.25 | $1,445.44 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,073.80 Typical High $5,623.41 | Facility | None | $630.96 | $4,073.80 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,230.27 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $3,981.07 | Facility | None | $1,174.90 | $1,445.44 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,412.54 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $758.58 Typical High $1,288.25 | Professional | None | $120.23 | $758.58 | $1,288.25 |
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 $870.96 Median $1,122.02 Typical High $1,819.70 | Professional | None | $870.96 | $1,122.02 | $1,819.70 |
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 $524.81 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $524.81 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $776.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $851.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,290.87 Typical High $2,884.03 | Professional | 50 · Both sides | $1,949.84 | $2,290.87 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $758.58 Typical High $954.99 | Professional | 51 · Multiple procedures | $645.65 | $758.58 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $302.00 Typical High $380.19 | Professional | 80 · Assistant surgeon | $257.04 | $302.00 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $213.80 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $181.97 | $213.80 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $213.80 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $213.80 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $269.15 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $269.15 |
Where South Carolina sits
The same service costs 4.2 times more in Colorado 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
CO $14,362MT $3,396
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.