How much rates vary
Facilitymedian $4,169 · 10th to 90th $977 to $19,055Professionalmedian $692 · 10th to 90th $107 to $1,047
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 $851.14 Median $10,471.29 Typical High $21,877.62 | Facility | None | $851.14 | $10,471.29 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,096.48 | Professional | None | $724.44 | $851.14 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,230.27 | Professional | None | $630.96 | $933.25 | $1,230.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,071.52 Median $5,370.32 Typical High $18,620.87 | Facility | None | $1,071.52 | $5,370.32 | $18,620.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,202.26 | Professional | None | $676.08 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $5,623.41 | Facility | None | $630.96 | $2,951.21 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,348.96 | Professional | None | $851.14 | $851.14 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $933.25 Typical High $3,981.07 | Facility | None | $758.58 | $933.25 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,122.02 | Professional | None | $851.14 | $1,000.00 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $912.01 | Professional | None | $79.43 | $524.81 | $912.01 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,258.93 | Professional | None | $616.60 | $776.25 | $1,258.93 |
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 $363.08 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $363.08 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $602.56 | $602.56 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,584.89 Typical High $1,995.26 | Professional | 50 · Both sides | $1,348.96 | $1,584.89 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $524.81 Typical High $660.69 | Professional | 51 · Multiple procedures | $457.09 | $524.81 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $208.93 Typical High $263.03 | Professional | 80 · Assistant surgeon | $181.97 | $208.93 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $147.91 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $125.89 | $147.91 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $147.91 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $147.91 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $186.21 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $186.21 |
Where South Carolina sits
The same service costs 5.7 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 $13,613MT $2,377
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.