How much rates vary
Facilitymedian $2,138 · 10th to 90th $933 to $18,197Professionalmedian $759 · 10th to 90th $102 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 $933.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $933.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $933.25 | Professional | None | $794.33 | $933.25 | $933.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $5,128.61 Typical High $19,054.61 | Facility | None | $1,047.13 | $5,128.61 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,023.29 | Professional | None | $724.44 | $831.76 | $1,023.29 |
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 $891.25 Median $912.01 Typical High $1,445.44 | Professional | None | $891.25 | $912.01 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $977.24 Typical High $2,238.72 | Facility | None | $758.58 | $977.24 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,071.52 | Professional | None | $933.25 | $1,000.00 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $602.56 Typical High $1,023.29 | Professional | None | $79.43 | $602.56 | $1,023.29 |
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 $660.69 Median $851.14 Typical High $1,348.96 | Professional | None | $660.69 | $851.14 | $1,348.96 |
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 $398.11 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $588.84 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $117.49 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $549.54 | $645.65 | $645.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,584.89 Typical High $2,137.96 | Professional | 50 · Both sides | $1,445.44 | $1,584.89 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $524.81 Typical High $724.44 | Professional | 51 · Multiple procedures | $478.63 | $524.81 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $208.93 Typical High $288.40 | Professional | 80 · Assistant surgeon | $190.55 | $208.93 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $147.91 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $134.90 | $147.91 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $147.91 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $147.91 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $147.91 Typical High $199.53 | Professional | AS · PA/NP assist | $134.90 | $147.91 | $199.53 |
Where South Carolina sits
The same service costs 3.1 times more in Wisconsin than in Maryland. 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 $8,115MD $2,591
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.