How much rates vary
Facilitymedian $1,122 · 10th to 90th $417 to $8,511Professionalmedian $2,455 · 10th to 90th $1,698 to $3,236
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 $2,454.71 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,454.71 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,454.71 | $2,454.71 |
BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $2,951.21 | Professional | None | $1,698.24 | $2,570.40 | $2,951.21 |
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 $1,995.26 Median $2,238.72 Typical High $5,128.61 | Professional | None | $1,995.26 | $2,238.72 | $5,128.61 |
Medcost Setting Facility Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $3,311.31 | Facility | None | $2,454.71 | $2,691.53 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $2,951.21 | Professional | None | $1,949.84 | $2,630.27 | $2,951.21 |
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 $1,737.80 Median $2,187.76 Typical High $3,981.07 | Professional | None | $1,737.80 | $2,187.76 | $3,981.07 |
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 $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,023.29 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,548.82 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $309.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,737.80 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $977.24 | $1,479.11 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $588.84 Typical High $588.84 | Professional | 80 · Assistant surgeon | $389.05 | $588.84 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $269.15 | $416.87 | $416.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $416.87 | $416.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | AS · PA/NP assist | $269.15 | $416.87 | $416.87 |
Where South Carolina sits
The same service costs 9.8 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.
South Carolina· 28th of 51
$2,455
AK $8,511KY $871
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.