How much rates vary
Facilitymedian $5,370 · 10th to 90th $813 to $20,417Professionalmedian $676 · 10th to 90th $107 to $1,072
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 $812.83 Median $9,772.37 Typical High $21,877.62 | Facility | None | $812.83 | $9,772.37 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,096.48 | Professional | None | $691.83 | $812.83 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $691.83 Typical High $1,174.90 | Professional | None | $158.49 | $691.83 | $1,174.90 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $6,165.95 Typical High $19,054.61 | Facility | None | $851.14 | $6,165.95 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,288.25 | Professional | None | $630.96 | $912.01 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $7,413.10 | Facility | None | $602.56 | $2,398.83 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,288.25 | Professional | None | $812.83 | $812.83 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $6,165.95 | Facility | None | $630.96 | $812.83 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,148.15 | Professional | None | $812.83 | $954.99 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $891.25 | Professional | None | $79.43 | $524.81 | $891.25 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,165.95 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,165.95 | $23,988.33 |
United Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,202.26 | Professional | None | $588.84 | $741.31 | $1,202.26 |
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 $346.74 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $524.81 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $575.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,513.56 Typical High $1,905.46 | Professional | 50 · Both sides | $1,288.25 | $1,513.56 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $512.86 Typical High $630.96 | Professional | 51 · Multiple procedures | $426.58 | $512.86 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $251.19 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $141.25 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $120.23 | $141.25 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $141.25 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $141.25 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $177.83 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $177.83 |
Where South Carolina sits
The same service costs 6.1 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 $13,882MT $2,270
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.