How much rates vary
Facilitymedian $3,311 · 10th to 90th $933 to $14,125Professionalmedian $741 · 10th to 90th $447 to $1,047
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 $776.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $776.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $794.33 | Professional | None | $616.60 | $776.25 | $794.33 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,365.16 Typical High $13,182.57 | Facility | None | $1,047.13 | $4,365.16 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,445.44 | Professional | None | $562.34 | $812.83 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $4,677.35 | Facility | None | $630.96 | $2,951.21 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $1,380.38 | Professional | None | $707.95 | $724.44 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $2,089.30 | Facility | None | $707.95 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,000.00 | Professional | None | $724.44 | $831.76 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $676.08 Typical High $1,023.29 | Professional | None | $66.07 | $676.08 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,318.26 | Professional | None | $602.56 | $794.33 | $1,318.26 |
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 $309.03 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $93.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $436.52 | $549.54 | $549.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $416.87 Typical High $562.34 | Professional | 51 · Multiple procedures | $380.19 | $416.87 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $165.96 Typical High $223.87 | Professional | 80 · Assistant surgeon | $151.36 | $165.96 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $117.49 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $107.15 | $117.49 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $117.49 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $117.49 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $117.49 Typical High $158.49 | Professional | AS · PA/NP assist | $107.15 | $117.49 | $158.49 |
Where South Carolina sits
The same service costs 5.1 times more in Wisconsin 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
WI $10,170MT $2,000
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.