How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,380 to $17,783Professionalmedian $1,023 · 10th to 90th $107 to $1,698
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 $1,318.26 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,318.26 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,318.26 | $1,318.26 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,659.59 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,659.59 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,819.70 | Professional | None | $954.99 | $1,258.93 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,235.94 Typical High $4,677.35 | Facility | None | $602.56 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,288.25 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $3,890.45 | Facility | None | $1,148.15 | $1,778.28 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,412.54 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $851.14 Typical High $1,621.81 | Professional | None | $91.20 | $851.14 | $1,621.81 |
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 $1,000.00 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,288.25 | $2,238.72 |
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 $537.03 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $213.80 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $758.58 | $933.25 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,089.30 Typical High $2,951.21 | Professional | 50 · Both sides | $2,041.74 | $2,089.30 | $2,951.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $707.95 Typical High $977.24 | Professional | 51 · Multiple procedures | $691.83 | $707.95 | $977.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $281.84 Typical High $389.05 | Professional | 80 · Assistant surgeon | $275.42 | $281.84 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $194.98 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $190.55 | $194.98 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $194.98 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $194.98 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $194.98 Typical High $275.42 | Professional | AS · PA/NP assist | $190.55 | $194.98 | $275.42 |
Where South Carolina sits
The same service costs 3.4 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 $11,546MT $3,436
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.