How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,202 to $13,183Professionalmedian $550 · 10th to 90th $93 to $955
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 $691.83 Median $13,182.57 Typical High $22,908.68 | Facility | None | $691.83 | $13,182.57 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $691.83 | Professional | None | $588.84 | $691.83 | $691.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $4,168.69 Typical High $12,302.69 | Facility | None | $1,621.81 | $4,168.69 | $12,302.69 |
BCBS South Carolina Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,148.15 | Professional | None | $524.81 | $831.76 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,511.89 | Facility | None | $602.56 | $1,819.70 | $2,511.89 |
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 $616.60 Median $758.58 Typical High $2,137.96 | Facility | None | $616.60 | $758.58 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,000.00 | Professional | None | $691.83 | $812.83 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $707.95 | Professional | None | $79.43 | $426.58 | $707.95 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,071.52 | Professional | None | $512.86 | $660.69 | $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 $295.12 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $446.68 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $89.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $416.87 | $478.63 | $478.63 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,445.44 Typical High $1,621.81 | Professional | 50 · Both sides | $1,174.90 | $1,445.44 | $1,621.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $478.63 Typical High $537.03 | Professional | 51 · Multiple procedures | $389.05 | $478.63 | $537.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $190.55 Typical High $213.80 | Professional | 80 · Assistant surgeon | $154.88 | $190.55 | $213.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $134.90 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $109.65 | $134.90 | $151.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $134.90 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $134.90 | $151.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $134.90 Typical High $151.36 | Professional | AS · PA/NP assist | $109.65 | $134.90 | $151.36 |
Where South Carolina sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.