How much rates vary
Facilitymedian $1,778 · 10th to 90th $661 to $7,244Professionalmedian $550 · 10th to 90th $363 to $741
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 $602.56 Median $10,000.00 Typical High $21,877.62 | Facility | None | $602.56 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | None | $501.19 | $602.56 | $602.56 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $7,079.46 | Facility | None | $851.14 | $2,290.87 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $602.56 | Professional | None | $426.58 | $588.84 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,621.81 Typical High $2,398.83 | Facility | None | $602.56 | $1,621.81 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $831.76 | Professional | None | $537.03 | $549.54 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,202.26 | Professional | None | $691.83 | $741.31 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $707.95 Typical High $1,698.24 | Facility | None | $588.84 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $676.08 | Professional | None | $537.03 | $630.96 | $676.08 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $467.74 Typical High $741.31 | Professional | None | $58.88 | $467.74 | $741.31 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $912.01 | Professional | None | $426.58 | $524.81 | $912.01 |
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 $251.19 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $251.19 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $100.00 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $371.54 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $74.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $50.12 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $346.74 | $426.58 | $426.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $331.13 Typical High $363.08 | Professional | 51 · Multiple procedures | $269.15 | $331.13 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $134.90 Typical High $144.54 | Professional | 80 · Assistant surgeon | $107.15 | $134.90 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $75.86 Median $93.33 Typical High $102.33 | Professional | 81 · Minimal assistant surgeon | $75.86 | $93.33 | $102.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $75.86 Median $93.33 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $75.86 | $93.33 | $102.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $93.33 Typical High $102.33 | Professional | AS · PA/NP assist | $75.86 | $93.33 | $102.33 |
Where South Carolina sits
The same service costs 3.9 times more in Colorado than in Delaware. 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 $5,057DE $1,284
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.