How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $10,715Professionalmedian $398 · 10th to 90th $78 to $603
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 $467.74 Median $9,772.37 Typical High $21,877.62 | Facility | None | $467.74 | $9,772.37 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $524.81 | Professional | None | $407.38 | $467.74 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,905.46 Typical High $9,549.93 | Facility | None | $851.14 | $1,905.46 | $9,549.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $602.56 | Professional | None | $338.84 | $416.87 | $602.56 |
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 $489.78 Median $537.03 Typical High $741.31 | Professional | None | $489.78 | $537.03 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $1,584.89 Typical High $1,621.81 | Facility | None | $467.74 | $1,584.89 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $549.54 | Professional | None | $467.74 | $512.86 | $549.54 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $338.84 Typical High $549.54 | Professional | None | $64.57 | $338.84 | $549.54 |
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 $426.58 Typical High $707.95 | Professional | None | $338.84 | $426.58 | $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 $302.00 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $331.13 | $331.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $794.33 Typical High $1,096.48 | Professional | 50 · Both sides | $776.25 | $794.33 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $263.03 Typical High $363.08 | Professional | 51 · Multiple procedures | $257.04 | $263.03 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $104.71 Typical High $144.54 | Professional | 80 · Assistant surgeon | $102.33 | $104.71 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $74.13 Typical High $102.33 | Professional | 81 · Minimal assistant surgeon | $72.44 | $74.13 | $102.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $74.13 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $74.13 | $102.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $74.13 Typical High $102.33 | Professional | AS · PA/NP assist | $72.44 | $74.13 | $102.33 |
Where South Carolina sits
The same service costs 5.1 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 $6,741MT $1,322
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.