How much rates vary
Facilitymedian $6,607 · 10th to 90th $955 to $21,380Professionalmedian $562 · 10th to 90th $95 to $912
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 $10,964.78 Typical High $21,877.62 | Facility | None | $707.95 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $831.76 | Professional | None | $602.56 | $707.95 | $831.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $7,413.10 Typical High $21,379.62 | Facility | None | $1,047.13 | $7,413.10 | $21,379.62 |
BCBS South Carolina Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,096.48 | Professional | None | $549.54 | $851.14 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $14,791.08 | Facility | None | $630.96 | $2,951.21 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $1,122.02 | Professional | None | $724.44 | $741.31 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $912.01 Typical High $5,128.61 | Facility | None | $691.83 | $912.01 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,000.00 | Professional | None | $707.95 | $758.58 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $741.31 | Professional | None | $79.43 | $446.68 | $741.31 |
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 $630.96 Typical High $1,071.52 | Professional | None | $501.19 | $630.96 | $1,071.52 |
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 $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $302.00 | $354.81 | $354.81 |
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 $1,148.15 Median $1,318.26 Typical High $1,659.59 | Professional | 50 · Both sides | $1,148.15 | $1,318.26 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $436.52 Typical High $562.34 | Professional | 51 · Multiple procedures | $380.19 | $436.52 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $223.87 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $123.03 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $107.15 | $123.03 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $123.03 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $123.03 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $123.03 Typical High $154.88 | Professional | AS · PA/NP assist | $107.15 | $123.03 | $154.88 |
Where South Carolina sits
The same service costs 10.1 times more in Alaska 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
AK $19,890MT $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.