How much rates vary
Facilitymedian $1,862 · 10th to 90th $759 to $10,233Professionalmedian $331 · 10th to 90th $89 to $513
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 $389.05 Median $10,000.00 Typical High $21,877.62 | Facility | None | $389.05 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $389.05 | Professional | None | $331.13 | $389.05 | $389.05 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,818.38 Typical High $9,120.11 | Facility | None | $851.14 | $2,818.38 | $9,120.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $501.19 | Professional | None | $309.03 | $346.74 | $501.19 |
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 $426.58 Median $436.52 Typical High $630.96 | Professional | None | $426.58 | $436.52 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $741.31 Typical High $1,698.24 | Facility | None | $389.05 | $741.31 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $549.54 | Professional | None | $389.05 | $446.68 | $549.54 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $281.84 Typical High $457.09 | Professional | None | $75.86 | $281.84 | $457.09 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $630.96 | Professional | None | $281.84 | $371.54 | $630.96 |
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 $165.96 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $165.96 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $66.07 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $50.12 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $234.42 | $269.15 | $269.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $724.44 Typical High $912.01 | Professional | 50 · Both sides | $630.96 | $724.44 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $239.88 Typical High $302.00 | Professional | 51 · Multiple procedures | $208.93 | $239.88 | $302.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $120.23 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $120.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $58.88 Median $67.61 Typical High $85.11 | Professional | 81 · Minimal assistant surgeon | $58.88 | $67.61 | $85.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $58.88 Median $67.61 Typical High $85.11 | Professional | 82 · Assistant surgeon, no resident | $58.88 | $67.61 | $85.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $67.61 Typical High $85.11 | Professional | AS · PA/NP assist | $58.88 | $67.61 | $85.11 |
Where South Carolina sits
The same service costs 6.0 times more in Colorado 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
CO $6,645MT $1,112
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.