How much rates vary
Facilitymedian $5,012 · 10th to 90th $832 to $19,498Professionalmedian $832 · 10th to 90th $107 to $1,445
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 $1,000.00 Median $1,258.93 Typical High $20,417.38 | Facility | None | $1,000.00 | $1,258.93 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,258.93 | Professional | None | $851.14 | $1,000.00 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $1,202.26 Typical High $1,445.44 | Professional | None | $194.98 | $1,202.26 | $1,445.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $870.96 Median $5,754.40 Typical High $18,197.01 | Facility | None | $870.96 | $5,754.40 | $18,197.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,445.44 | Professional | None | $794.33 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $7,413.10 | Facility | None | $602.56 | $2,398.83 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,000.00 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $4,265.80 | Facility | None | $630.96 | $1,000.00 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,096.48 | $1,258.93 |
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 $707.95 Median $891.25 Typical High $1,479.11 | Professional | None | $707.95 | $891.25 | $1,479.11 |
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 $426.58 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $645.65 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $602.56 | $707.95 | $707.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,862.09 Typical High $2,344.23 | Professional | 50 · Both sides | $1,513.56 | $1,862.09 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $630.96 Typical High $776.25 | Professional | 51 · Multiple procedures | $512.86 | $630.96 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $251.19 Typical High $309.03 | Professional | 80 · Assistant surgeon | $204.17 | $251.19 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $173.78 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $141.25 | $173.78 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $173.78 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $173.78 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $218.78 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $218.78 |
Where South Carolina sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.