How much rates vary
Facilitymedian $2,138 · 10th to 90th $955 to $12,882Professionalmedian $813 · 10th to 90th $105 to $1,259
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 $1,023.29 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,023.29 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | None | $870.96 | $1,023.29 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,047.13 | $3,801.89 | $11,481.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,174.90 | Professional | None | $794.33 | $851.14 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $2,818.38 | Facility | None | $630.96 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,047.13 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $2,137.96 | Facility | None | $794.33 | $1,023.29 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,023.29 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $676.08 Typical High $1,148.15 | Professional | None | $79.43 | $676.08 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,548.82 | Professional | None | $724.44 | $933.25 | $1,548.82 |
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 $436.52 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $707.95 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $645.65 Typical High $794.33 | Professional | 51 · Multiple procedures | $501.19 | $645.65 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $257.04 Typical High $316.23 | Professional | 80 · Assistant surgeon | $204.17 | $257.04 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $177.83 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $141.25 | $177.83 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $177.83 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $177.83 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $223.87 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $223.87 |
Where South Carolina sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.