How much rates vary
Facilitymedian $4,898 · 10th to 90th $794 to $25,704Professionalmedian $617 · 10th to 90th $102 to $1,047
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 $776.25 Median $10,000.00 Typical High $21,877.62 | Facility | None | $776.25 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $776.25 | Professional | None | $660.69 | $776.25 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $5,370.32 Typical High $30,199.52 | Facility | None | $851.14 | $5,370.32 | $30,199.52 |
BCBS South Carolina Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,047.13 | Professional | None | $602.56 | $851.14 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $7,244.36 | Facility | None | $602.56 | $2,398.83 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,230.27 | Professional | None | $831.76 | $912.01 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $831.76 Typical High $4,786.30 | Facility | None | $630.96 | $831.76 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,318.26 | Professional | None | $776.25 | $870.96 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $478.63 Typical High $812.83 | Professional | None | $79.43 | $478.63 | $812.83 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,348.96 | Professional | None | $549.54 | $724.44 | $1,348.96 |
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 $331.13 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,445.44 Typical High $1,995.26 | Professional | 50 · Both sides | $1,288.25 | $1,445.44 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $489.78 Typical High $660.69 | Professional | 51 · Multiple procedures | $426.58 | $489.78 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $194.98 Typical High $263.03 | Professional | 80 · Assistant surgeon | $169.82 | $194.98 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $134.90 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $120.23 | $134.90 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $134.90 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $134.90 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $134.90 Typical High $186.21 | Professional | AS · PA/NP assist | $120.23 | $134.90 | $186.21 |
Where South Carolina sits
The same service costs 6.4 times more in Colorado 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
CO $13,837MT $2,168
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.