How much rates vary
Facilitymedian $5,888 · 10th to 90th $955 to $33,113Professionalmedian $676 · 10th to 90th $102 to $1,072
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 $851.14 Median $10,964.78 Typical High $21,877.62 | Facility | None | $851.14 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | None | $724.44 | $851.14 | $851.14 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $36,307.81 | Facility | None | $1,047.13 | $7,943.28 | $36,307.81 |
BCBS South Carolina Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,288.25 | Professional | None | $645.65 | $977.24 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $7,943.28 | Facility | None | $630.96 | $2,951.21 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,318.26 | Professional | None | $851.14 | $870.96 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $933.25 Typical High $4,168.69 | Facility | None | $758.58 | $933.25 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,174.90 | Professional | None | $851.14 | $1,000.00 | $1,174.90 |
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 $1,819.70 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 $602.56 Median $758.58 Typical High $1,258.93 | Professional | None | $602.56 | $758.58 | $1,258.93 |
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 $354.81 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $588.84 | $588.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,584.89 Typical High $1,949.84 | Professional | 50 · Both sides | $1,318.26 | $1,584.89 | $1,949.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $524.81 Typical High $645.65 | Professional | 51 · Multiple procedures | $446.68 | $524.81 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $263.03 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $147.91 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $123.03 | $147.91 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $147.91 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $147.91 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $147.91 Typical High $181.97 | Professional | AS · PA/NP assist | $123.03 | $147.91 | $181.97 |
Where South Carolina sits
The same service costs 6.2 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 $14,513MT $2,350
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.