How much rates vary
Facilitymedian $1,349 · 10th to 90th $162 to $3,388Professionalmedian $282 · 10th to 90th $49 to $490
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 $234.42 Median $5,623.41 Typical High $21,877.62 | Facility | None | $234.42 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $331.13 | Professional | None | $229.09 | $263.03 | $331.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $3,630.78 | Facility | None | $1,174.90 | $2,041.74 | $3,630.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $380.19 | Professional | None | $177.83 | $269.15 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $501.19 Typical High $977.24 | Facility | None | $213.80 | $501.19 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $549.54 | Professional | None | $234.42 | $323.59 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $724.44 | Facility | None | $218.78 | $371.54 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $398.11 | Professional | None | $263.03 | $363.08 | $398.11 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $281.84 Typical High $501.19 | Professional | None | $37.15 | $281.84 | $501.19 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $524.81 | Professional | None | $204.17 | $323.59 | $524.81 |
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 $114.82 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $114.82 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $52.48 Typical High $67.61 | Professional | 53 · Discontinued | $46.77 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $199.53 Typical High $251.19 | Professional | 54 · Surgery only | $173.78 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $50.12 | Professional | 55 · Aftercare only | $34.67 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $33.11 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $186.21 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $162.18 | $186.21 | $234.42 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $181.97 Typical High $251.19 | Professional | 51 · Multiple procedures | $131.83 | $181.97 | $251.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $72.44 Typical High $100.00 | Professional | 80 · Assistant surgeon | $63.10 | $72.44 | $100.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $44.67 Median $51.29 Typical High $70.79 | Professional | 81 · Minimal assistant surgeon | $44.67 | $51.29 | $70.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $44.67 Median $51.29 Typical High $70.79 | Professional | 82 · Assistant surgeon, no resident | $44.67 | $51.29 | $70.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $51.29 Typical High $70.79 | Professional | AS · PA/NP assist | $44.67 | $51.29 | $70.79 |
Where South Carolina sits
The same service costs 3.7 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.
South Carolina· 42nd of 51
$288
WI $891TX $240
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.