How much rates vary
Facilitymedian $1,905 · 10th to 90th $891 to $11,220Professionalmedian $363 · 10th to 90th $257 to $513
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 $354.81 Median $10,471.29 Typical High $21,877.62 | Facility | None | $354.81 | $10,471.29 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | None | $281.84 | $354.81 | $354.81 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $3,388.44 Typical High $10,471.29 | Facility | None | $1,023.29 | $3,388.44 | $10,471.29 |
BCBS South Carolina Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $602.56 | Professional | None | $263.03 | $426.58 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,122.02 Typical High $1,819.70 | Facility | None | $630.96 | $1,122.02 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $630.96 | Professional | None | $323.59 | $331.13 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $812.83 Typical High $1,348.96 | Facility | None | $323.59 | $812.83 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $524.81 | Professional | None | $331.13 | $389.05 | $524.81 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $501.19 | Professional | None | $234.42 | $346.74 | $501.19 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $588.84 | Professional | None | $281.84 | $354.81 | $588.84 |
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 $141.25 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $141.25 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $56.23 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $42.66 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.18 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $199.53 | $245.47 | $245.47 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $194.98 Typical High $269.15 | Professional | 51 · Multiple procedures | $177.83 | $194.98 | $269.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $77.62 Typical High $107.15 | Professional | 80 · Assistant surgeon | $70.79 | $77.62 | $107.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $53.70 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $50.12 | $53.70 | $75.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $53.70 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $53.70 | $75.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $53.70 Typical High $75.86 | Professional | AS · PA/NP assist | $50.12 | $53.70 | $75.86 |
Where South Carolina sits
The same service costs 6.6 times more in Oklahoma 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
OK $6,126MT $925
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.