How much rates vary
Facilitymedian $339 · 10th to 90th $100 to $1,738Professionalmedian $288 · 10th to 90th $105 to $407
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 $302.00 Median $4,897.79 Typical High $21,877.62 | Facility | None | $302.00 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $338.84 | Professional | None | $281.84 | $302.00 | $338.84 |
BCBS South Carolina Setting Facility Modifier None Typical Low $257.04 Median $436.52 Typical High $758.58 | Facility | None | $257.04 | $436.52 | $758.58 |
BCBS South Carolina Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $380.19 | Professional | None | $213.80 | $338.84 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $165.96 Typical High $269.15 | Facility | None | $75.86 | $165.96 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $478.63 | Professional | None | $302.00 | $323.59 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $234.42 Typical High $407.38 | Facility | None | $95.50 | $234.42 | $407.38 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $446.68 | Professional | None | $338.84 | $398.11 | $446.68 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $194.98 Typical High $323.59 | Professional | None | $72.44 | $194.98 | $323.59 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $457.09 | Professional | None | $218.78 | $275.42 | $457.09 |
11 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 $141.25 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $67.61 | Professional | 53 · Discontinued | $56.23 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $234.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $204.17 Typical High $263.03 | Professional | 51 · Multiple procedures | $169.82 | $204.17 | $263.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $81.28 Typical High $104.71 | Professional | 80 · Assistant surgeon | $69.18 | $81.28 | $104.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $57.54 Typical High $74.13 | Professional | 81 · Minimal assistant surgeon | $47.86 | $57.54 | $74.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $57.54 Typical High $74.13 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $57.54 | $74.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $57.54 Typical High $74.13 | Professional | AS · PA/NP assist | $47.86 | $57.54 | $74.13 |
Where South Carolina sits
The same service costs 10.5 times more in Colorado than in Florida. 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 $4,157FL $396
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.