How much rates vary
Facilitymedian $2,042 · 10th to 90th $794 to $13,490Professionalmedian $589 · 10th to 90th $102 to $891
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 $741.31 Median $10,000.00 Typical High $21,877.62 | Facility | None | $741.31 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | None | $630.96 | $741.31 | $741.31 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $12,589.25 | Facility | None | $851.14 | $3,548.13 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $977.24 | Professional | None | $575.44 | $794.33 | $977.24 |
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 $741.31 Median $758.58 Typical High $1,174.90 | Professional | None | $741.31 | $758.58 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $1,778.28 | Facility | None | $616.60 | $794.33 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $977.24 | Professional | None | $741.31 | $831.76 | $977.24 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $794.33 | Professional | None | $79.43 | $457.09 | $794.33 |
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 $524.81 Median $660.69 Typical High $1,096.48 | Professional | None | $524.81 | $660.69 | $1,096.48 |
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 $316.23 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $467.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $512.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,380.38 Typical High $1,737.80 | Professional | 50 · Both sides | $1,148.15 | $1,380.38 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $467.74 Typical High $575.44 | Professional | 51 · Multiple procedures | $389.05 | $467.74 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $186.21 Typical High $229.09 | Professional | 80 · Assistant surgeon | $154.88 | $186.21 | $229.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $128.82 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $107.15 | $128.82 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $128.82 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $128.82 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $162.18 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $162.18 |
Where South Carolina sits
The same service costs 3.7 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 $7,647MT $2,070
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.