How much rates vary
Facilitymedian $661 · 10th to 90th $151 to $1,202Professionalmedian $550 · 10th to 90th $102 to $832
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 $575.44 Median $5,623.41 Typical High $21,877.62 | Facility | None | $575.44 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $588.84 | Professional | None | $489.78 | $575.44 | $588.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $302.00 Median $676.08 Typical High $933.25 | Facility | None | $302.00 | $676.08 | $933.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $831.76 | Professional | None | $457.09 | $676.08 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $407.38 Typical High $977.24 | Facility | None | $151.36 | $407.38 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $891.25 | Professional | None | $549.54 | $562.34 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $588.84 Typical High $851.14 | Facility | None | $95.50 | $588.84 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $776.25 | Professional | None | $588.84 | $645.65 | $776.25 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $724.44 | Professional | None | $79.43 | $416.87 | $724.44 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $851.14 | Professional | None | $407.38 | $512.86 | $851.14 |
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 $251.19 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $407.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,096.48 Typical High $1,348.96 | Professional | 50 · Both sides | $891.25 | $1,096.48 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $363.08 Typical High $457.09 | Professional | 51 · Multiple procedures | $295.12 | $363.08 | $457.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $144.54 Typical High $181.97 | Professional | 80 · Assistant surgeon | $117.49 | $144.54 | $181.97 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $102.33 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $83.18 | $102.33 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $102.33 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $102.33 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $102.33 Typical High $125.89 | Professional | AS · PA/NP assist | $83.18 | $102.33 | $125.89 |
Where South Carolina sits
The same service costs 5.2 times more in Connecticut than in Florida. 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
CT $3,486FL $668
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.