How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $12,882Professionalmedian $182 · 10th to 90th $141 to $263
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 $204.17 Median $10,964.78 Typical High $21,877.62 | Facility | None | $204.17 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | None | $173.78 | $204.17 | $204.17 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $13,182.57 | Facility | None | $1,548.82 | $4,073.80 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $309.03 | Professional | None | $144.54 | $169.82 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $186.21 Median $1,778.28 Typical High $2,754.23 | Facility | None | $186.21 | $1,778.28 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $295.12 | Professional | None | $144.54 | $165.96 | $295.12 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $257.04 | Professional | None | $131.83 | $181.97 | $257.04 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $309.03 | Professional | None | $147.91 | $190.55 | $309.03 |
10 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 $87.10 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $34.67 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.38 | $20.42 | $20.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $83.18 Typical High $158.49 | Professional | 51 · Multiple procedures | $72.44 | $83.18 | $158.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $33.11 Typical High $63.10 | Professional | 80 · Assistant surgeon | $28.84 | $33.11 | $63.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $23.44 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $19.95 | $23.44 | $43.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $23.44 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $23.44 | $43.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.95 Median $23.44 Typical High $43.65 | Professional | AS · PA/NP assist | $19.95 | $23.44 | $43.65 |
Where South Carolina sits
The same service costs 11.9 times more in Oklahoma 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
OK $6,102MT $514
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.