How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $10,471Professionalmedian $427 · 10th to 90th $93 to $617
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 $478.63 Median $10,000.00 Typical High $21,877.62 | Facility | None | $478.63 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $645.65 | Professional | None | $407.38 | $478.63 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $9,332.54 | Facility | None | $851.14 | $2,137.96 | $9,332.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $537.03 | Professional | None | $354.81 | $467.74 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,548.82 Typical High $3,090.30 | Facility | None | $602.56 | $1,548.82 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $758.58 | Professional | None | $501.19 | $537.03 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $1,174.90 Typical High $1,584.89 | Facility | None | $467.74 | $1,174.90 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $562.34 | Professional | None | $478.63 | $512.86 | $562.34 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $354.81 Typical High $562.34 | Professional | None | $75.86 | $354.81 | $562.34 |
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 $338.84 Median $436.52 Typical High $707.95 | Professional | None | $338.84 | $436.52 | $707.95 |
8 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 54 · Surgery only Typical Low $309.03 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $288.40 | $338.84 | $338.84 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $794.33 Typical High $1,122.02 | Professional | 50 · Both sides | $776.25 | $794.33 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $263.03 Typical High $371.54 | Professional | 51 · Multiple procedures | $257.04 | $263.03 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $107.15 Typical High $147.91 | Professional | 80 · Assistant surgeon | $104.71 | $107.15 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $74.13 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $72.44 | $74.13 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $74.13 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $74.13 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $74.13 Typical High $104.71 | Professional | AS · PA/NP assist | $72.44 | $74.13 | $104.71 |
Where South Carolina sits
The same service costs 4.9 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 $6,755MT $1,384
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.