How much rates vary
Facilitymedian $631 · 10th to 90th $102 to $1,778Professionalmedian $219 · 10th to 90th $49 to $380
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 $144.54 Median $4,897.79 Typical High $21,877.62 | Facility | None | $144.54 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $316.23 | Professional | None | $138.04 | $218.78 | $316.23 |
BCBS South Carolina Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $1,584.89 | Facility | None | $501.19 | $851.14 | $1,584.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $245.47 | Professional | None | $104.71 | $128.82 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $147.91 Typical High $234.42 | Facility | None | $75.86 | $147.91 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $416.87 | Professional | None | $120.23 | $234.42 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $331.13 | Facility | None | $141.25 | $218.78 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $354.81 | Professional | None | $239.88 | $275.42 | $354.81 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $229.09 Typical High $398.11 | Professional | None | $37.15 | $229.09 | $398.11 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $112.20 Median $223.87 Typical High $389.05 | Professional | None | $112.20 | $223.87 | $389.05 |
11 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 $70.79 Median $74.13 Typical High $158.49 | Professional | 52 · Reduced service | $70.79 | $74.13 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $29.51 Typical High $64.57 | Professional | 53 · Discontinued | $28.84 | $29.51 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $112.20 Typical High $239.88 | Professional | 54 · Surgery only | $107.15 | $112.20 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $47.86 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.79 Typical High $31.62 | Professional | 56 · Pre-op care only | $14.45 | $14.79 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $104.71 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $100.00 | $104.71 | $223.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $158.49 Typical High $234.42 | Professional | 51 · Multiple procedures | $120.23 | $158.49 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $63.10 Typical High $93.33 | Professional | 80 · Assistant surgeon | $47.86 | $63.10 | $93.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.11 Median $43.65 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $33.11 | $43.65 | $66.07 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.11 Median $43.65 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $33.11 | $43.65 | $66.07 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $43.65 Typical High $66.07 | Professional | AS · PA/NP assist | $33.11 | $43.65 | $66.07 |
Where South Carolina sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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.
South Carolina· 27th of 51
$229
WI $490KY $135
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.