How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,288 to $17,783Professionalmedian $759 · 10th to 90th $102 to $1,202
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 $977.24 Median $9,120.11 Typical High $22,908.68 | Facility | None | $977.24 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $977.24 | Professional | None | $831.76 | $977.24 | $977.24 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,548.82 Median $3,630.78 Typical High $14,125.38 | Facility | None | $1,548.82 | $3,630.78 | $14,125.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,548.82 | Professional | None | $724.44 | $1,148.15 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,511.89 | Facility | None | $602.56 | $1,862.09 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,047.13 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,000.00 Typical High $3,630.78 | Facility | None | $794.33 | $1,000.00 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,412.54 | Professional | None | $977.24 | $1,258.93 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $575.44 Typical High $1,000.00 | Professional | None | $79.43 | $575.44 | $1,000.00 |
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 $912.01 Typical High $1,479.11 | Professional | None | $707.95 | $912.01 | $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 $416.87 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $165.96 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $676.08 | $676.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,905.46 Typical High $2,238.72 | Professional | 50 · Both sides | $1,621.81 | $1,905.46 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $630.96 Typical High $758.58 | Professional | 51 · Multiple procedures | $549.54 | $630.96 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $251.19 Typical High $302.00 | Professional | 80 · Assistant surgeon | $218.78 | $251.19 | $302.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $177.83 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $151.36 | $177.83 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $177.83 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $177.83 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $208.93 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $208.93 |
Where South Carolina sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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 $11,256KY $2,261
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.