How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,202 to $13,183Professionalmedian $589 · 10th to 90th $81 to $813
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 $602.56 Median $13,182.57 Typical High $22,908.68 | Facility | None | $602.56 | $13,182.57 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $602.56 | Professional | None | $512.86 | $602.56 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $446.68 | Professional | None | $60.26 | $60.26 | $446.68 |
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 $478.63 Median $660.69 Typical High $851.14 | Professional | None | $478.63 | $660.69 | $851.14 |
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 $602.56 Median $602.56 Typical High $954.99 | Professional | None | $602.56 | $602.56 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $741.31 Typical High $2,137.96 | Facility | None | $588.84 | $741.31 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,174.90 | Professional | None | $602.56 | $707.95 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $436.52 Typical High $691.83 | Professional | None | $72.44 | $436.52 | $691.83 |
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 $436.52 Median $549.54 Typical High $891.25 | Professional | None | $436.52 | $549.54 | $891.25 |
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 $257.04 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $51.29 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $426.58 | $426.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,148.15 Typical High $1,737.80 | Professional | 50 · Both sides | $954.99 | $1,148.15 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $380.19 Typical High $588.84 | Professional | 51 · Multiple procedures | $316.23 | $380.19 | $588.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $151.36 Typical High $234.42 | Professional | 80 · Assistant surgeon | $125.89 | $151.36 | $234.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $107.15 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $89.13 | $107.15 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $107.15 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $107.15 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $107.15 Typical High $162.18 | Professional | AS · PA/NP assist | $89.13 | $107.15 | $162.18 |
Where South Carolina sits
The same service costs 4.5 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 $7,632MT $1,703
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.