How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,122 to $17,783Professionalmedian $1,585 · 10th to 90th $219 to $2,512
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 $1,445.44 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,445.44 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,445.44 | $1,737.80 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,202.26 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,584.89 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $4,677.35 | Facility | None | $630.96 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,548.82 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,311.31 | Facility | None | $912.01 | $1,445.44 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,819.70 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,548.82 Typical High $2,570.40 | Professional | None | $162.18 | $1,548.82 | $2,570.40 |
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 $1,174.90 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,659.59 | $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 $676.08 Median $724.44 Typical High $870.96 | Professional | 52 · Reduced service | $676.08 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $288.40 Typical High $354.81 | Professional | 53 · Discontinued | $275.42 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $144.54 Typical High $173.78 | Professional | 56 · Pre-op care only | $134.90 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $912.01 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $891.25 | $912.01 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $363.08 Typical High $524.81 | Professional | 80 · Assistant surgeon | $354.81 | $363.08 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $251.19 | $251.19 | $371.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $251.19 | $371.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | AS · PA/NP assist | $251.19 | $251.19 | $371.54 |
Where South Carolina sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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 $12,311KY $3,892
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.