How much rates vary
Facilitymedian $6,918 · 10th to 90th $2,291 to $22,909Professionalmedian $1,479 · 10th to 90th $295 to $2,512
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 $2,344.23 Median $10,964.78 Typical High $21,877.62 | Facility | None | $2,344.23 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,995.26 | $2,344.23 | $2,344.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $3,467.37 Median $6,918.31 Typical High $27,542.29 | Facility | None | $3,467.37 | $6,918.31 | $27,542.29 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,348.96 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $5,623.41 | Facility | None | $602.56 | $4,073.80 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $3,548.13 | Professional | None | $1,148.15 | $1,148.15 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $2,344.23 Typical High $8,317.64 | Facility | None | $870.96 | $2,344.23 | $8,317.64 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,412.54 | $2,187.76 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $1,445.44 Typical High $2,454.71 | Professional | None | $239.88 | $1,445.44 | $2,454.71 |
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 $1,258.93 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,258.93 | $1,949.84 | $3,311.31 |
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 $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,000.00 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $398.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,513.56 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,621.81 | $1,621.81 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $3,311.31 Typical High $5,495.41 | Professional | 50 · Both sides | $2,089.30 | $3,311.31 | $5,495.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $1,096.48 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $707.95 | $1,096.48 | $1,819.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $436.52 Typical High $724.44 | Professional | 80 · Assistant surgeon | $281.84 | $436.52 | $724.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $309.03 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $194.98 | $309.03 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $309.03 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $309.03 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $309.03 Typical High $512.86 | Professional | AS · PA/NP assist | $194.98 | $309.03 | $512.86 |
Where South Carolina sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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
AK $18,090KY $3,723
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.