How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,202 to $13,183Professionalmedian $794 · 10th to 90th $105 to $1,202
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 $954.99 Median $13,182.57 Typical High $22,908.68 | Facility | None | $954.99 | $13,182.57 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,174.90 | Professional | None | $831.76 | $954.99 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $4,265.80 Typical High $12,302.69 | Facility | None | $1,621.81 | $4,265.80 | $12,302.69 |
BCBS South Carolina Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,380.38 | Professional | None | $741.31 | $933.25 | $1,380.38 |
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 $954.99 Median $954.99 Typical High $1,548.82 | Professional | None | $954.99 | $954.99 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $2,238.72 | Facility | None | $630.96 | $954.99 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $2,137.96 | Professional | None | $954.99 | $1,122.02 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $630.96 Typical High $1,071.52 | Professional | None | $79.43 | $630.96 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,548.13 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,548.13 | $18,197.01 |
United Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,412.54 | Professional | None | $691.83 | $870.96 | $1,412.54 |
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 $407.38 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $165.96 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $616.60 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $83.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $575.44 | $676.08 | $676.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $3,162.28 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $602.56 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $501.19 | $602.56 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $426.58 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $169.82 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $141.25 | $169.82 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $169.82 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $169.82 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $295.12 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $295.12 |
Where South Carolina sits
The same service costs 3.2 times more in Wisconsin than in Maryland. 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 $8,354MD $2,629
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.