How much rates vary
Facilitymedian $2,570 · 10th to 90th $851 to $13,183Professionalmedian $794 · 10th to 90th $138 to $1,175
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 $1,000.00 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,000.00 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | None | $870.96 | $1,000.00 | $1,000.00 |
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 $794.33 Median $870.96 Typical High $1,148.15 | Professional | None | $794.33 | $870.96 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $2,137.96 | Facility | None | $630.96 | $1,000.00 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,380.38 | Professional | None | $977.24 | $1,000.00 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $645.65 Typical High $1,122.02 | Professional | None | $117.49 | $645.65 | $1,122.02 |
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 $691.83 Median $891.25 Typical High $1,479.11 | Professional | None | $691.83 | $891.25 | $1,479.11 |
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 $426.58 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $691.83 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $630.96 Typical High $776.25 | Professional | 51 · Multiple procedures | $489.78 | $630.96 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $251.19 Typical High $309.03 | Professional | 80 · Assistant surgeon | $199.53 | $251.19 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $173.78 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $138.04 | $173.78 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $173.78 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $173.78 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $173.78 Typical High $218.78 | Professional | AS · PA/NP assist | $138.04 | $173.78 | $218.78 |
Where South Carolina sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.