How much rates vary
Facilitymedian $4,898 · 10th to 90th $794 to $19,953Professionalmedian $603 · 10th to 90th $105 to $912
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 $724.44 Median $9,772.37 Typical High $21,877.62 | Facility | None | $724.44 | $9,772.37 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $812.83 | Professional | None | $616.60 | $724.44 | $812.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $5,011.87 Typical High $18,197.01 | Facility | None | $851.14 | $5,011.87 | $18,197.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,047.13 | Professional | None | $562.34 | $851.14 | $1,047.13 |
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 $724.44 Median $724.44 Typical High $1,122.02 | Professional | None | $724.44 | $724.44 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $2,691.53 | Facility | None | $616.60 | $794.33 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,023.29 | Professional | None | $724.44 | $831.76 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $812.83 | Professional | None | $79.43 | $457.09 | $812.83 |
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 $512.86 Median $645.65 Typical High $1,096.48 | Professional | None | $512.86 | $645.65 | $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 $309.03 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $501.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,348.96 Typical High $1,659.59 | Professional | 50 · Both sides | $1,096.48 | $1,348.96 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $446.68 Typical High $562.34 | Professional | 51 · Multiple procedures | $371.54 | $446.68 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $177.83 Typical High $223.87 | Professional | 80 · Assistant surgeon | $147.91 | $177.83 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $125.89 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $102.33 | $125.89 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $125.89 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $125.89 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $125.89 Typical High $154.88 | Professional | AS · PA/NP assist | $102.33 | $125.89 | $154.88 |
Where South Carolina sits
The same service costs 6.8 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 $13,753MT $2,023
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.