How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,380 · 10th to 90th $178 to $2,291
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 $1,698.24 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,698.24 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,698.24 | $1,698.24 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,778.28 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,584.89 | $1,698.24 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $3,890.45 | Facility | None | $1,202.26 | $1,698.24 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,905.46 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,174.90 Typical High $2,238.72 | Professional | None | $162.18 | $1,174.90 | $2,238.72 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,698.24 | $2,884.03 |
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 $691.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $954.99 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $912.01 | $954.99 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $380.19 Typical High $512.86 | Professional | 80 · Assistant surgeon | $371.54 | $380.19 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $269.15 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $257.04 | $269.15 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $269.15 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $269.15 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $269.15 Typical High $354.81 | Professional | AS · PA/NP assist | $257.04 | $269.15 | $354.81 |
Where South Carolina sits
The same service costs 7.8 times more in Colorado than in Washington. 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
CO $16,544WA $2,120
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.