How much rates vary
Facilitymedian $1,122 · 10th to 90th $490 to $9,772Professionalmedian $316 · 10th to 90th $59 to $490
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 $208.93 Median $4,897.79 Typical High $21,877.62 | Facility | None | $208.93 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $371.54 | Professional | None | $208.93 | $302.00 | $371.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,023.29 Typical High $8,912.51 | Facility | None | $512.86 | $1,023.29 | $8,912.51 |
BCBS South Carolina Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $489.78 | Professional | None | $165.96 | $288.40 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $954.99 Typical High $1,445.44 | Facility | None | $457.09 | $954.99 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $389.05 Typical High $524.81 | Professional | None | $234.42 | $389.05 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $457.09 Typical High $1,096.48 | Facility | None | $208.93 | $457.09 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $660.69 | Professional | None | $371.54 | $426.58 | $660.69 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $323.59 Typical High $489.78 | Professional | None | $37.15 | $323.59 | $489.78 |
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 $162.18 Median $295.12 Typical High $549.54 | Professional | None | $162.18 | $295.12 | $549.54 |
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 $104.71 Median $138.04 Typical High $186.21 | Professional | 52 · Reduced service | $104.71 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $54.95 Typical High $74.13 | Professional | 53 · Discontinued | $42.66 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $208.93 Typical High $281.84 | Professional | 54 · Surgery only | $158.49 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $41.69 Typical High $56.23 | Professional | 55 · Aftercare only | $31.62 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $27.54 Typical High $37.15 | Professional | 56 · Pre-op care only | $20.89 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $194.98 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $147.91 | $194.98 | $263.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $707.95 Typical High $977.24 | Professional | 50 · Both sides | $630.96 | $707.95 | $977.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $234.42 Typical High $331.13 | Professional | 51 · Multiple procedures | $208.93 | $234.42 | $331.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $93.33 Typical High $131.83 | Professional | 80 · Assistant surgeon | $83.18 | $93.33 | $131.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $58.88 Median $66.07 Typical High $91.20 | Professional | 81 · Minimal assistant surgeon | $58.88 | $66.07 | $91.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $58.88 Median $66.07 Typical High $91.20 | Professional | 82 · Assistant surgeon, no resident | $58.88 | $66.07 | $91.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $66.07 Typical High $91.20 | Professional | AS · PA/NP assist | $58.88 | $66.07 | $91.20 |
Where South Carolina sits
The same service costs 6.4 times more in Oklahoma than in North Dakota. 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
OK $5,125ND $804
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.