How much rates vary
Facilitymedian $1,023 · 10th to 90th $603 to $7,586Professionalmedian $575 · 10th to 90th $105 to $813
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 $575.44 Median $5,623.41 Typical High $21,877.62 | Facility | None | $575.44 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $645.65 | Professional | None | $501.19 | $575.44 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $7,762.47 | Facility | None | $676.08 | $1,202.26 | $7,762.47 |
BCBS South Carolina Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $707.95 | Professional | None | $457.09 | $616.60 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $1,584.89 | Facility | None | $602.56 | $977.24 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $912.01 | Professional | None | $562.34 | $616.60 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $630.96 Typical High $1,380.38 | Facility | None | $512.86 | $630.96 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $831.76 | Professional | None | $630.96 | $707.95 | $831.76 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $794.33 | Professional | None | $79.43 | $457.09 | $794.33 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $870.96 | Professional | None | $416.87 | $549.54 | $870.96 |
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 $269.15 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $269.15 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $107.15 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $398.11 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $436.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,174.90 Typical High $1,479.11 | Professional | 50 · Both sides | $954.99 | $1,174.90 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $398.11 Typical High $489.78 | Professional | 51 · Multiple procedures | $323.59 | $398.11 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $158.49 Typical High $194.98 | Professional | 80 · Assistant surgeon | $128.82 | $158.49 | $194.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $109.65 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $89.13 | $109.65 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $109.65 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $109.65 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $109.65 Typical High $138.04 | Professional | AS · PA/NP assist | $89.13 | $109.65 | $138.04 |
Where South Carolina sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.