How much rates vary
Facilitymedian $2,089 · 10th to 90th $933 to $13,804Professionalmedian $661 · 10th to 90th $105 to $1,023
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 $794.33 Median $10,964.78 Typical High $21,877.62 | Facility | None | $794.33 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $870.96 | Professional | None | $676.08 | $794.33 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $3,890.45 Typical High $12,589.25 | Facility | None | $1,047.13 | $3,890.45 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,148.15 | Professional | None | $616.60 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $2,818.38 | Facility | None | $630.96 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,230.27 | Professional | None | $776.25 | $776.25 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $2,089.30 | Facility | None | $758.58 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,148.15 | Professional | None | $794.33 | $912.01 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $501.19 Typical High $870.96 | Professional | None | $79.43 | $501.19 | $870.96 |
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 $707.95 Typical High $1,148.15 | Professional | None | $562.34 | $707.95 | $1,148.15 |
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 $338.84 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,479.11 Typical High $1,819.70 | Professional | 50 · Both sides | $1,202.26 | $1,479.11 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $489.78 Typical High $616.60 | Professional | 51 · Multiple procedures | $407.38 | $489.78 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $199.53 Typical High $245.47 | Professional | 80 · Assistant surgeon | $162.18 | $199.53 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $138.04 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $112.20 | $138.04 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $138.04 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $138.04 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $138.04 Typical High $169.82 | Professional | AS · PA/NP assist | $112.20 | $138.04 | $169.82 |
Where South Carolina sits
The same service costs 3.5 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 $7,845MT $2,218
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.