How much rates vary
Facilitymedian $2,630 · 10th to 90th $513 to $13,183Professionalmedian $776 · 10th to 90th $102 to $1,288
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 $954.99 Median $5,623.41 Typical High $21,877.62 | Facility | None | $954.99 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $954.99 | Professional | None | $758.58 | $954.99 | $954.99 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $2,754.23 Typical High $12,882.50 | Facility | None | $512.86 | $2,754.23 | $12,882.50 |
BCBS South Carolina Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $1,148.15 | Professional | None | $691.83 | $707.95 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $4,168.69 | Facility | None | $457.09 | $1,479.11 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,698.24 | Professional | None | $831.76 | $891.25 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $630.96 Typical High $2,137.96 | Facility | None | $436.52 | $630.96 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,148.15 | Professional | None | $794.33 | $851.14 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $776.25 Typical High $1,258.93 | Professional | None | $81.28 | $776.25 | $1,258.93 |
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 $758.58 Median $954.99 Typical High $1,621.81 | Professional | None | $758.58 | $954.99 | $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 $380.19 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $676.08 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $426.58 Typical High $724.44 | Professional | 51 · Multiple procedures | $398.11 | $426.58 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $169.82 Typical High $275.42 | Professional | 80 · Assistant surgeon | $162.18 | $169.82 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $117.49 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $112.20 | $117.49 | $194.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $117.49 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $117.49 | $194.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $117.49 Typical High $194.98 | Professional | AS · PA/NP assist | $112.20 | $117.49 | $194.98 |
Where South Carolina sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.