How much rates vary
Facilitymedian $4,898 · 10th to 90th $794 to $19,953Professionalmedian $646 · 10th to 90th $105 to $977
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 $8,912.51 Typical High $20,417.38 | Facility | None | $776.25 | $8,912.51 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $831.76 | Professional | None | $660.69 | $776.25 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $5,495.41 Typical High $18,197.01 | Facility | None | $851.14 | $5,495.41 | $18,197.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,148.15 | Professional | None | $602.56 | $870.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $7,079.46 | Facility | None | $602.56 | $2,398.83 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Professional | None | $758.58 | $758.58 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $4,265.80 | Facility | None | $616.60 | $794.33 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,047.13 | Professional | None | $776.25 | $954.99 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $851.14 | Professional | None | $79.43 | $489.78 | $851.14 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,148.15 | Professional | None | $549.54 | $691.83 | $1,148.15 |
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 $489.78 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $114.82 |
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 $457.09 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $537.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,479.11 Typical High $1,778.28 | Professional | 50 · Both sides | $1,174.90 | $1,479.11 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $489.78 Typical High $602.56 | Professional | 51 · Multiple procedures | $398.11 | $489.78 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $194.98 Typical High $239.88 | Professional | 80 · Assistant surgeon | $158.49 | $194.98 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $138.04 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $109.65 | $138.04 | $165.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $138.04 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $138.04 | $165.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $138.04 Typical High $165.96 | Professional | AS · PA/NP assist | $109.65 | $138.04 | $165.96 |
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 $13,816MT $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.