How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,288 to $20,893Professionalmedian $708 · 10th to 90th $102 to $1,122
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 $891.25 Median $12,022.64 Typical High $22,908.68 | Facility | None | $891.25 | $12,022.64 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $891.25 | Professional | None | $758.58 | $891.25 | $891.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $19,952.62 | Facility | None | $1,698.24 | $6,456.54 | $19,952.62 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,348.96 | Professional | None | $691.83 | $1,047.13 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,623.41 Typical High $9,332.54 | Facility | None | $630.96 | $5,623.41 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $1,412.54 | Professional | None | $891.25 | $912.01 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $977.24 Typical High $4,466.84 | Facility | None | $758.58 | $977.24 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,288.25 | Professional | None | $891.25 | $1,047.13 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $537.03 Typical High $933.25 | Professional | None | $79.43 | $537.03 | $933.25 |
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 $645.65 Median $812.83 Typical High $1,318.26 | Professional | None | $645.65 | $812.83 | $1,318.26 |
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 $380.19 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $630.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,698.24 Typical High $2,089.30 | Professional | 50 · Both sides | $1,412.54 | $1,698.24 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $562.34 Typical High $707.95 | Professional | 51 · Multiple procedures | $467.74 | $562.34 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $229.09 Typical High $281.84 | Professional | 80 · Assistant surgeon | $186.21 | $229.09 | $281.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $158.49 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $131.83 | $158.49 | $194.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $158.49 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $158.49 | $194.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $158.49 Typical High $194.98 | Professional | AS · PA/NP assist | $131.83 | $158.49 | $194.98 |
Where South Carolina sits
The same service costs 5.9 times more in Alaska 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
AK $14,644MT $2,489
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.