How much rates vary
Facilitymedian $2,042 · 10th to 90th $661 to $10,000Professionalmedian $525 · 10th to 90th $83 to $741
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 $537.03 Median $5,888.44 Typical High $21,877.62 | Facility | None | $537.03 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $602.56 | Professional | None | $457.09 | $537.03 | $602.56 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $2,884.03 Typical High $9,120.11 | Facility | None | $691.83 | $2,884.03 | $9,120.11 |
BCBS South Carolina Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $851.14 | Professional | None | $426.58 | $645.65 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $5,623.41 | Facility | None | $602.56 | $1,995.26 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $851.14 | Professional | None | $575.44 | $588.84 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $4,570.88 | Facility | None | $537.03 | $676.08 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,047.13 | Professional | None | $537.03 | $630.96 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $389.05 Typical High $630.96 | Professional | None | $72.44 | $389.05 | $630.96 |
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 $389.05 Median $501.19 Typical High $851.14 | Professional | None | $389.05 | $501.19 | $851.14 |
11 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 $229.09 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $229.09 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $93.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $323.59 | $380.19 | $380.19 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $338.84 Typical High $524.81 | Professional | 51 · Multiple procedures | $302.00 | $338.84 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $134.90 Typical High $208.93 | Professional | 80 · Assistant surgeon | $120.23 | $134.90 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $95.50 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $83.18 | $95.50 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $95.50 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $95.50 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $95.50 Typical High $144.54 | Professional | AS · PA/NP assist | $83.18 | $95.50 | $144.54 |
Where South Carolina sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.