How much rates vary
Facilitymedian $2,042 · 10th to 90th $776 to $13,490Professionalmedian $537 · 10th to 90th $93 to $933
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 $645.65 Median $10,000.00 Typical High $21,877.62 | Facility | None | $645.65 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | None | $549.54 | $645.65 | $645.65 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,235.94 Typical High $12,589.25 | Facility | None | $851.14 | $3,235.94 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $933.25 | Professional | None | $512.86 | $549.54 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,071.52 | Professional | None | $660.69 | $776.25 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $1,698.24 | Facility | None | $616.60 | $741.31 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,148.15 | Professional | None | $645.65 | $741.31 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $724.44 | Professional | None | $79.43 | $416.87 | $724.44 |
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 $457.09 Median $588.84 Typical High $1,202.26 | Professional | None | $457.09 | $588.84 | $1,202.26 |
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 $275.42 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $416.87 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $54.95 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $389.05 | $446.68 | $446.68 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $407.38 Typical High $575.44 | Professional | 51 · Multiple procedures | $354.81 | $407.38 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $162.18 Typical High $234.42 | Professional | 80 · Assistant surgeon | $141.25 | $162.18 | $234.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $112.20 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $100.00 | $112.20 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $100.00 Median $112.20 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $100.00 | $112.20 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $112.20 Typical High $162.18 | Professional | AS · PA/NP assist | $100.00 | $112.20 | $162.18 |
Where South Carolina sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.