How much rates vary
Facilitymedian $5,495 · 10th to 90th $794 to $21,380Professionalmedian $575 · 10th to 90th $102 to $832
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 $707.95 Median $10,000.00 Typical High $21,877.62 | Facility | None | $707.95 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $707.95 | Professional | None | $602.56 | $707.95 | $707.95 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $5,623.41 Typical High $20,417.38 | Facility | None | $851.14 | $5,623.41 | $20,417.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $912.01 | Professional | None | $549.54 | $741.31 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $8,128.31 | Facility | None | $602.56 | $2,398.83 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,071.52 | Professional | None | $630.96 | $630.96 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $776.25 Typical High $3,090.30 | Facility | None | $616.60 | $776.25 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,071.52 | Professional | None | $645.65 | $812.83 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $776.25 | Professional | None | $79.43 | $446.68 | $776.25 |
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 $501.19 Median $616.60 Typical High $1,023.29 | Professional | None | $501.19 | $616.60 | $1,023.29 |
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 $302.00 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $446.68 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $416.87 | $489.78 | $489.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,258.93 Typical High $1,621.81 | Professional | 50 · Both sides | $977.24 | $1,258.93 | $1,621.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $416.87 Typical High $549.54 | Professional | 51 · Multiple procedures | $323.59 | $416.87 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $165.96 Typical High $218.78 | Professional | 80 · Assistant surgeon | $128.82 | $165.96 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $117.49 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $91.20 | $117.49 | $151.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $117.49 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $117.49 | $151.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $117.49 Typical High $151.36 | Professional | AS · PA/NP assist | $91.20 | $117.49 | $151.36 |
Where South Carolina sits
The same service costs 7.1 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 $14,034MT $1,977
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.