How much rates vary
Facilitymedian $2,042 · 10th to 90th $813 to $12,882Professionalmedian $741 · 10th to 90th $102 to $1,096
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 $912.01 Median $10,000.00 Typical High $21,877.62 | Facility | None | $912.01 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | None | $794.33 | $912.01 | $912.01 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,951.21 Typical High $11,481.54 | Facility | None | $851.14 | $2,951.21 | $11,481.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $977.24 | Professional | None | $660.69 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,412.54 | Professional | None | $870.96 | $891.25 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $2,137.96 | Facility | None | $630.96 | $912.01 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,230.27 | Professional | None | $870.96 | $1,000.00 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $602.56 Typical High $1,071.52 | Professional | None | $79.43 | $602.56 | $1,071.52 |
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 $630.96 Median $794.33 Typical High $1,288.25 | Professional | None | $630.96 | $794.33 | $1,288.25 |
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 $398.11 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $398.11 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $588.84 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $117.49 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $79.43 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $549.54 | $645.65 | $645.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $575.44 Typical High $707.95 | Professional | 51 · Multiple procedures | $436.52 | $575.44 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $229.09 Typical High $281.84 | Professional | 80 · Assistant surgeon | $173.78 | $229.09 | $281.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $158.49 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $123.03 | $158.49 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $158.49 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $158.49 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $158.49 Typical High $199.53 | Professional | AS · PA/NP assist | $123.03 | $158.49 | $199.53 |
Where South Carolina sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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 $7,619HI $2,493
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.