How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $2,630 · 10th to 90th $288 to $4,169
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 $3,388.44 Median $9,120.11 Typical High $22,908.68 | Facility | None | $3,388.44 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,818.38 | $3,388.44 | $3,388.44 |
BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,398.83 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $4,677.35 | Professional | None | $2,884.03 | $2,884.03 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $3,801.89 Median $4,073.80 Typical High $6,309.57 | Professional | None | $3,801.89 | $4,073.80 | $6,309.57 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $4,570.88 | Facility | None | $724.44 | $724.44 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $3,548.13 | Professional | None | $2,884.03 | $3,388.44 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $2,290.87 Typical High $4,265.80 | Professional | None | $263.03 | $2,290.87 | $4,265.80 |
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 $2,344.23 Median $2,884.03 Typical High $4,786.30 | Professional | None | $2,344.23 | $2,884.03 | $4,786.30 |
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 $1,412.54 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,412.54 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $575.44 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,137.96 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $426.58 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,398.83 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,778.28 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $1,445.44 | $1,778.28 | $2,041.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $707.95 Typical High $831.76 | Professional | 80 · Assistant surgeon | $575.44 | $707.95 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $501.19 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $407.38 | $501.19 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $501.19 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $501.19 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $501.19 Typical High $575.44 | Professional | AS · PA/NP assist | $407.38 | $501.19 | $575.44 |
Where South Carolina sits
The same service costs 21.4 times more in Alaska 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· 45th of 51
$2,630
AK $9,772TX $457
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.