How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,148 to $13,183Professionalmedian $513 · 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 $616.60 Median $9,120.11 Typical High $21,877.62 | Facility | None | $616.60 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $794.33 | Professional | None | $524.81 | $616.60 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $549.54 | Professional | None | $371.54 | $371.54 | $549.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $4,365.16 Typical High $12,022.64 | Facility | None | $1,621.81 | $4,365.16 | $12,022.64 |
BCBS South Carolina Setting Professional Modifier None Typical Low $489.78 Median $870.96 Typical High $1,071.52 | Professional | None | $489.78 | $870.96 | $1,071.52 |
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 $660.69 Median $660.69 Typical High $1,023.29 | Professional | None | $660.69 | $660.69 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $2,137.96 | Facility | None | $616.60 | $741.31 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,230.27 | Professional | None | $616.60 | $831.76 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $407.38 Typical High $676.08 | Professional | None | $79.43 | $407.38 | $676.08 |
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 $467.74 Median $588.84 Typical High $977.24 | Professional | None | $467.74 | $588.84 | $977.24 |
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 $263.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $263.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $398.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $52.48 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $371.54 | $436.52 | $436.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,230.27 Typical High $1,819.70 | Professional | 50 · Both sides | $1,023.29 | $1,230.27 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $407.38 Typical High $602.56 | Professional | 51 · Multiple procedures | $338.84 | $407.38 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $245.47 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $95.50 Median $114.82 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $95.50 | $114.82 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $114.82 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $114.82 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $114.82 Typical High $169.82 | Professional | AS · PA/NP assist | $95.50 | $114.82 | $169.82 |
Where South Carolina sits
The same service costs 4.7 times more in Connecticut 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
CT $8,304MT $1,762
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.