How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,047 to $13,183Professionalmedian $933 · 10th to 90th $195 to $1,349
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 $676.08 Median $9,120.11 Typical High $20,417.38 | Facility | None | $676.08 | $9,120.11 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,230.27 | Professional | None | $676.08 | $912.01 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,230.27 Median $4,786.30 Typical High $12,589.25 | Facility | None | $1,230.27 | $4,786.30 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $537.03 Median $1,023.29 Typical High $1,318.26 | Professional | None | $537.03 | $1,023.29 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,388.44 Typical High $7,244.36 | Facility | None | $630.96 | $3,388.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,548.82 | Professional | None | $794.33 | $1,000.00 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,047.13 Typical High $2,754.23 | Facility | None | $676.08 | $1,047.13 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,148.15 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $794.33 Typical High $1,348.96 | Professional | None | $117.49 | $794.33 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $4,265.80 Typical High $19,498.45 | Facility | None | $1,023.29 | $4,265.80 | $19,498.45 |
United Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,445.44 | Professional | None | $512.86 | $891.25 | $1,445.44 |
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 $338.84 Median $416.87 Typical High $575.44 | Professional | 52 · Reduced service | $338.84 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $169.82 Typical High $229.09 | Professional | 53 · Discontinued | $134.90 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $630.96 Typical High $851.14 | Professional | 54 · Surgery only | $512.86 | $630.96 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $125.89 Typical High $169.82 | Professional | 55 · Aftercare only | $102.33 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $85.11 Typical High $114.82 | Professional | 56 · Pre-op care only | $67.61 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $588.84 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $478.63 | $588.84 | $794.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,737.80 Typical High $2,630.27 | Professional | 50 · Both sides | $1,621.81 | $1,737.80 | $2,630.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $575.44 Typical High $891.25 | Professional | 51 · Multiple procedures | $537.03 | $575.44 | $891.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $234.42 Typical High $354.81 | Professional | 80 · Assistant surgeon | $213.80 | $234.42 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $162.18 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $151.36 | $162.18 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $162.18 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $162.18 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $162.18 Typical High $245.47 | Professional | AS · PA/NP assist | $151.36 | $162.18 | $245.47 |
Where South Carolina sits
The same service costs 5.1 times more in Alaska than in West Virginia. 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 $10,217WV $2,002
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.