How much rates vary
Facilitymedian $13,183 · 10th to 90th $1,514 to $46,774Professionalmedian $1,585 · 10th to 90th $245 to $2,570
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 $2,041.74 Median $12,022.64 Typical High $21,877.62 | Facility | None | $2,041.74 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,737.80 | $2,041.74 | $2,041.74 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $16,218.10 Typical High $51,286.14 | Facility | None | $1,621.81 | $16,218.10 | $51,286.14 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,995.26 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $13,182.57 Typical High $21,877.62 | Facility | None | $602.56 | $13,182.57 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,454.71 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $1,949.84 Median $10,000.00 Typical High $13,489.63 | Facility | None | $1,949.84 | $10,000.00 | $13,489.63 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,344.23 | Professional | None | $2,041.74 | $2,290.87 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $1,202.26 Typical High $2,089.30 | Professional | None | $204.17 | $1,202.26 | $2,089.30 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $11,220.18 Typical High $30,199.52 | Facility | None | $3,311.31 | $11,220.18 | $30,199.52 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,479.11 | $1,905.46 | $3,311.31 |
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 $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $870.96 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,288.25 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,412.54 | $1,412.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | 50 · Both sides | $3,467.37 | $3,467.37 | $4,677.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,148.15 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $1,148.15 | $1,148.15 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | 80 · Assistant surgeon | $457.09 | $457.09 | $630.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $323.59 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $323.59 | $323.59 | $436.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $323.59 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $323.59 | $436.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $323.59 Typical High $436.52 | Professional | AS · PA/NP assist | $323.59 | $323.59 | $436.52 |
Where South Carolina sits
The same service costs 7.8 times more in Alaska 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
AK $31,233KY $3,989
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.