How much rates vary
Facilitymedian $2,884 · 10th to 90th $437 to $9,120Professionalmedian $4,365 · 10th to 90th $603 to $7,413
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 $5,754.40 Median $9,120.11 Typical High $22,908.68 | Facility | None | $5,754.40 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $4,677.35 Median $5,754.40 Typical High $5,754.40 | Professional | None | $4,677.35 | $5,754.40 | $5,754.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $6,309.57 | Professional | None | $4,168.69 | $4,365.16 | $6,309.57 |
Medcost Setting Facility Modifier None Typical Low $3,162.28 Median $5,754.40 Typical High $12,882.50 | Facility | None | $3,162.28 | $5,754.40 | $12,882.50 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $5,128.61 Typical High $6,309.57 | Professional | None | $4,265.80 | $5,128.61 | $6,309.57 |
Molina Setting Professional Modifier None Typical Low $562.34 Median $3,981.07 Typical High $7,413.10 | Professional | None | $562.34 | $3,981.07 | $7,413.10 |
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 $3,981.07 Median $5,128.61 Typical High $8,511.38 | Professional | None | $3,981.07 | $5,128.61 | $8,511.38 |
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 $2,344.23 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $2,344.23 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $933.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,548.13 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $707.95 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $467.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,311.31 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $3,311.31 | $3,981.07 | $3,981.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,137.96 Median $2,570.40 Typical High $4,265.80 | Professional | 51 · Multiple procedures | $2,137.96 | $2,570.40 | $4,265.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $851.14 Median $1,023.29 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $851.14 | $1,023.29 | $1,698.24 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $602.56 Median $707.95 Typical High $1,174.90 | Professional | 81 · Minimal assistant surgeon | $602.56 | $707.95 | $1,174.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $602.56 Median $707.95 Typical High $1,174.90 | Professional | 82 · Assistant surgeon, no resident | $602.56 | $707.95 | $1,174.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $602.56 Median $707.95 Typical High $1,174.90 | Professional | AS · PA/NP assist | $602.56 | $707.95 | $1,174.90 |
Where South Carolina sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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 $28,671TX $3,407
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.