How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,047 to $12,882Professionalmedian $661 · 10th to 90th $105 to $977
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 $831.76 Median $10,964.78 Typical High $21,877.62 | Facility | None | $831.76 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | None | $707.95 | $831.76 | $831.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,202.26 | $3,801.89 | $11,481.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $851.14 | Professional | None | $575.44 | $660.69 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $2,951.21 | Facility | None | $630.96 | $1,819.70 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,288.25 | Professional | None | $758.58 | $812.83 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $1,047.13 Typical High $2,137.96 | Facility | None | $758.58 | $1,047.13 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,096.48 | Professional | None | $741.31 | $831.76 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $549.54 Typical High $912.01 | Professional | None | $79.43 | $549.54 | $912.01 |
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 $562.34 Median $724.44 Typical High $1,174.90 | Professional | None | $562.34 | $724.44 | $1,174.90 |
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 $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 $141.25 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $575.44 | $575.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $512.86 Typical High $645.65 | Professional | 51 · Multiple procedures | $371.54 | $512.86 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $208.93 Typical High $257.04 | Professional | 80 · Assistant surgeon | $147.91 | $208.93 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $144.54 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $104.71 | $144.54 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $144.54 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $144.54 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $144.54 Typical High $177.83 | Professional | AS · PA/NP assist | $104.71 | $144.54 | $177.83 |
Where South Carolina sits
The same service costs 3.2 times more in Wisconsin 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
WI $7,574MT $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.