How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,514 to $17,378Professionalmedian $912 · 10th to 90th $71 to $1,413
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 $1,122.02 Median $15,135.61 Typical High $24,547.09 | Facility | None | $1,122.02 | $15,135.61 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $891.25 | $1,122.02 | $1,122.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $5,370.32 Typical High $15,488.17 | Facility | None | $1,905.46 | $5,370.32 | $15,488.17 |
BCBS South Carolina Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,348.96 | Professional | None | $794.33 | $1,096.48 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,495.41 Typical High $7,762.47 | Facility | None | $630.96 | $5,495.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,047.13 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,122.02 Typical High $5,128.61 | Facility | None | $831.76 | $1,122.02 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,230.27 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $831.76 Typical High $1,412.54 | Professional | None | $66.07 | $831.76 | $1,412.54 |
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 $870.96 Median $1,122.02 Typical High $1,905.46 | Professional | None | $870.96 | $1,122.02 | $1,905.46 |
12 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 $446.68 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $177.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $89.13 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $776.25 | $776.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,819.70 Typical High $2,454.71 | Professional | 50 · Both sides | $1,659.59 | $1,819.70 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $616.60 Typical High $812.83 | Professional | 51 · Multiple procedures | $562.34 | $616.60 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $245.47 Typical High $323.59 | Professional | 80 · Assistant surgeon | $223.87 | $245.47 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $169.82 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $154.88 | $169.82 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $169.82 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $169.82 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $169.82 Typical High $229.09 | Professional | AS · PA/NP assist | $154.88 | $169.82 | $229.09 |
Where South Carolina sits
The same service costs 4.6 times more in Wyoming than in Montana. 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
WY $13,103MT $2,825
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.