How much rates vary
Facilitymedian $2,089 · 10th to 90th $933 to $13,804Professionalmedian $479 · 10th to 90th $89 to $851
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 $575.44 Median $10,964.78 Typical High $21,877.62 | Facility | None | $575.44 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $575.44 | Professional | None | $489.78 | $575.44 | $575.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $3,981.07 Typical High $12,589.25 | Facility | None | $1,047.13 | $3,981.07 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $851.14 | Professional | None | $446.68 | $501.19 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $2,818.38 | Facility | None | $630.96 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $977.24 | Professional | None | $602.56 | $691.83 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $912.01 Typical High $2,089.30 | Facility | None | $575.44 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,047.13 | Professional | None | $575.44 | $645.65 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $416.87 Typical High $645.65 | Professional | None | $77.62 | $416.87 | $645.65 |
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 $398.11 Median $524.81 Typical High $1,071.52 | Professional | None | $398.11 | $524.81 | $1,071.52 |
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 $239.88 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $48.98 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $398.11 | $398.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $371.54 Typical High $524.81 | Professional | 51 · Multiple procedures | $316.23 | $371.54 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $213.80 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $213.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $104.71 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $89.13 | $104.71 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $104.71 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $104.71 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $147.91 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $147.91 |
Where South Carolina sits
The same service costs 4.5 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 $7,285MT $1,607
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.