How much rates vary
Facilitymedian $2,089 · 10th to 90th $832 to $14,125Professionalmedian $724 · 10th to 90th $102 to $1,072
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 $870.96 Median $5,888.44 Typical High $21,877.62 | Facility | None | $870.96 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $870.96 | Professional | None | $660.69 | $870.96 | $870.96 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $14,454.40 | Facility | None | $851.14 | $3,548.13 | $14,454.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,258.93 | Professional | None | $602.56 | $831.76 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $3,090.30 | Facility | None | $602.56 | $1,949.84 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,479.11 | Professional | None | $758.58 | $851.14 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $2,238.72 | Facility | None | $707.95 | $912.01 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,000.00 | Professional | None | $676.08 | $933.25 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $645.65 Typical High $1,023.29 | Professional | None | $81.28 | $645.65 | $1,023.29 |
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 $645.65 Median $812.83 Typical High $1,445.44 | Professional | None | $645.65 | $812.83 | $1,445.44 |
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 $331.13 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $331.13 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $501.19 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $66.07 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $467.74 | $616.60 | $616.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $467.74 Typical High $630.96 | Professional | 51 · Multiple procedures | $436.52 | $467.74 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $186.21 Typical High $251.19 | Professional | 80 · Assistant surgeon | $173.78 | $186.21 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $131.83 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $120.23 | $131.83 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $131.83 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $131.83 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $131.83 Typical High $177.83 | Professional | AS · PA/NP assist | $120.23 | $131.83 | $177.83 |
Where South Carolina sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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 $7,369KY $1,773
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.