How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $1,047 · 10th to 90th $110 to $1,549
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 $1,174.90 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,174.90 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,174.90 | $1,174.90 |
BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,096.48 | Professional | None | $933.25 | $1,047.13 | $1,096.48 |
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 $954.99 Median $954.99 Typical High $1,621.81 | Professional | None | $954.99 | $954.99 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,230.27 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,584.89 | Facility | None | $724.44 | $724.44 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,148.15 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $977.24 Typical High $1,621.81 | Professional | None | $75.86 | $977.24 | $1,621.81 |
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 $812.83 Median $1,000.00 Typical High $1,621.81 | Professional | None | $812.83 | $1,000.00 | $1,621.81 |
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 $501.19 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $691.83 | $831.76 | $831.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $575.44 Typical High $707.95 | Professional | 51 · Multiple procedures | $501.19 | $575.44 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $229.09 Typical High $288.40 | Professional | 80 · Assistant surgeon | $199.53 | $229.09 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $162.18 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $138.04 | $162.18 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $162.18 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $162.18 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $199.53 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $199.53 |
Where South Carolina sits
The same service costs 4.9 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· 39th of 51
$1,047
AK $3,548TX $724
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.