How much rates vary
Facilitymedian $1,778 · 10th to 90th $501 to $10,233Professionalmedian $269 · 10th to 90th $182 to $339
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 $269.15 Median $5,623.41 Typical High $21,877.62 | Facility | None | $269.15 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $269.15 | Professional | None | $204.17 | $269.15 | $269.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $9,549.93 | Facility | None | $512.86 | $1,778.28 | $9,549.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $398.11 | Professional | None | $186.21 | $281.84 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $2,630.27 | Facility | None | $457.09 | $1,479.11 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $457.09 | Professional | None | $234.42 | $245.47 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $501.19 Typical High $1,202.26 | Facility | None | $234.42 | $501.19 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $331.13 | Professional | None | $229.09 | $239.88 | $331.13 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $316.23 | Professional | None | $165.96 | $223.87 | $316.23 |
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 $199.53 Median $251.19 Typical High $426.58 | Professional | None | $199.53 | $251.19 | $426.58 |
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 $102.33 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $102.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $40.74 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $151.36 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $30.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.42 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $190.55 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $141.25 | $190.55 | $190.55 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $407.38 Typical High $588.84 | Professional | 50 · Both sides | $338.84 | $407.38 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $134.90 Typical High $186.21 | Professional | 51 · Multiple procedures | $114.82 | $134.90 | $186.21 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $53.70 Typical High $74.13 | Professional | 80 · Assistant surgeon | $45.71 | $53.70 | $74.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $38.02 Typical High $52.48 | Professional | 81 · Minimal assistant surgeon | $31.62 | $38.02 | $52.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $38.02 Typical High $52.48 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $38.02 | $52.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $38.02 Typical High $52.48 | Professional | AS · PA/NP assist | $31.62 | $38.02 | $52.48 |
Where South Carolina sits
The same service costs 9.6 times more in Colorado 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
CO $6,197MT $647
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.