How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,000 to $19,055Professionalmedian $646 · 10th to 90th $93 to $1,122
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 $831.76 Median $10,964.78 Typical High $21,877.62 | Facility | None | $831.76 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | None | $707.95 | $831.76 | $831.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $5,370.32 Typical High $19,054.61 | Facility | None | $1,047.13 | $5,370.32 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,122.02 | Professional | None | $630.96 | $891.25 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $912.01 Typical High $2,137.96 | Facility | None | $794.33 | $912.01 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,380.38 | Professional | None | $831.76 | $1,023.29 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $891.25 | Professional | None | $79.43 | $524.81 | $891.25 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $21,379.62 | Facility | None | $1,445.44 | $4,265.80 | $21,379.62 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,445.44 | Professional | None | $588.84 | $758.58 | $1,445.44 |
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 $346.74 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $524.81 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $575.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $512.86 Typical High $691.83 | Professional | 51 · Multiple procedures | $457.09 | $512.86 | $691.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $204.17 Typical High $275.42 | Professional | 80 · Assistant surgeon | $181.97 | $204.17 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $144.54 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $128.82 | $144.54 | $190.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $144.54 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $144.54 | $190.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $144.54 Typical High $190.55 | Professional | AS · PA/NP assist | $128.82 | $144.54 | $190.55 |
Where South Carolina sits
The same service costs 4.4 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 $9,724MT $2,195
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.