How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,778 to $17,783Professionalmedian $1,479 · 10th to 90th $214 to $2,455
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 $1,905.46 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,905.46 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,905.46 | $1,905.46 |
BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $5,754.40 Typical High $17,378.01 | Facility | None | $1,905.46 | $5,754.40 | $17,378.01 |
BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,737.80 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,311.31 Typical High $5,495.41 | Facility | None | $602.56 | $3,311.31 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,621.81 | $1,737.80 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $3,890.45 | Facility | None | $1,584.89 | $1,949.84 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,949.84 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $1,288.25 Typical High $2,344.23 | Professional | None | $181.97 | $1,288.25 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,819.70 | $3,235.94 |
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 $794.33 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $794.33 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,174.90 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $158.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,348.96 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $977.24 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $912.01 | $977.24 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $389.05 Typical High $562.34 | Professional | 80 · Assistant surgeon | $363.08 | $389.05 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $275.42 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $257.04 | $275.42 | $398.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $275.42 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $275.42 | $398.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $275.42 Typical High $398.11 | Professional | AS · PA/NP assist | $257.04 | $275.42 | $398.11 |
Where South Carolina sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 44th of 51
$1,660
AK $6,457UT $1,023
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.