How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,288 to $20,893Professionalmedian $550 · 10th to 90th $89 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 $630.96 Median $13,182.57 Typical High $22,908.68 | Facility | None | $630.96 | $13,182.57 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | None | $537.03 | $630.96 | $630.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $6,165.95 Typical High $19,952.62 | Facility | None | $1,698.24 | $6,165.95 | $19,952.62 |
BCBS South Carolina Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $977.24 | Professional | None | $489.78 | $724.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $5,623.41 | Facility | None | $602.56 | $2,398.83 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $977.24 | Professional | None | $616.60 | $616.60 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $741.31 Typical High $4,466.84 | Facility | None | $602.56 | $741.31 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,230.27 | Professional | None | $630.96 | $724.44 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $457.09 Typical High $691.83 | Professional | None | $77.62 | $457.09 | $691.83 |
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 $446.68 Median $562.34 Typical High $933.25 | Professional | None | $446.68 | $562.34 | $933.25 |
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 $269.15 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $107.15 | $125.89 | $125.89 |
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 $53.70 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $53.70 | $63.10 | $63.10 |
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 $977.24 Median $1,174.90 Typical High $1,862.09 | Professional | 50 · Both sides | $977.24 | $1,174.90 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $389.05 Typical High $616.60 | Professional | 51 · Multiple procedures | $323.59 | $389.05 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $154.88 Typical High $245.47 | Professional | 80 · Assistant surgeon | $128.82 | $154.88 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $109.65 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $91.20 | $109.65 | $173.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $109.65 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $109.65 | $173.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $109.65 Typical High $173.78 | Professional | AS · PA/NP assist | $91.20 | $109.65 | $173.78 |
Where South Carolina sits
The same service costs 7.9 times more in Colorado 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
CO $13,941MT $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.