How much rates vary
Facilitymedian $6,607 · 10th to 90th $977 to $19,953Professionalmedian $832 · 10th to 90th $105 to $1,288
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 $1,023.29 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,023.29 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,148.15 | Professional | None | $870.96 | $1,023.29 | $1,148.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $6,918.31 Typical High $18,620.87 | Facility | None | $1,047.13 | $6,918.31 | $18,620.87 |
BCBS South Carolina Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,584.89 | Professional | None | $794.33 | $1,148.15 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $13,489.63 | Facility | None | $630.96 | $2,951.21 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,023.29 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $1,023.29 Typical High $8,511.38 | Facility | None | $776.25 | $1,023.29 | $8,511.38 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,230.27 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $645.65 Typical High $1,122.02 | Professional | None | $79.43 | $645.65 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,513.56 | Professional | None | $741.31 | $933.25 | $1,513.56 |
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 $436.52 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $660.69 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $616.60 | $724.44 | $724.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,905.46 Typical High $2,398.83 | Professional | 50 · Both sides | $1,584.89 | $1,905.46 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $645.65 Typical High $794.33 | Professional | 51 · Multiple procedures | $537.03 | $645.65 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $257.04 Typical High $316.23 | Professional | 80 · Assistant surgeon | $213.80 | $257.04 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $177.83 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $147.91 | $177.83 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $177.83 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $177.83 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $223.87 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $223.87 |
Where South Carolina sits
The same service costs 6.8 times more in Alaska 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
AK $19,480MT $2,858
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.