How much rates vary
Facilitymedian $2,239 · 10th to 90th $891 to $13,490Professionalmedian $525 · 10th to 90th $316 to $759
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 $549.54 Median $1,174.90 Typical High $20,417.38 | Facility | None | $549.54 | $1,174.90 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $616.60 | Professional | None | $436.52 | $549.54 | $616.60 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,466.84 Typical High $13,182.57 | Facility | None | $1,047.13 | $4,466.84 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $1,047.13 | Professional | None | $380.19 | $724.44 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $2,951.21 | Facility | None | $630.96 | $1,905.46 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $954.99 | Professional | None | $512.86 | $537.03 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $912.01 Typical High $2,290.87 | Facility | None | $537.03 | $912.01 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $707.95 | Professional | None | $467.74 | $602.56 | $707.95 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $467.74 Typical High $724.44 | Professional | None | $66.07 | $467.74 | $724.44 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $891.25 | Professional | None | $426.58 | $537.03 | $891.25 |
13 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 $213.80 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $213.80 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $63.10 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $42.66 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $295.12 | $389.05 | $389.05 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 50 · Both sides | $1,047.13 | $1,047.13 | $1,047.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $933.25 Typical High $1,348.96 | Professional | 50 · Both sides | $707.95 | $933.25 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $316.23 Typical High $407.38 | Professional | 51 · Multiple procedures | $234.42 | $316.23 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $125.89 Typical High $162.18 | Professional | 80 · Assistant surgeon | $93.33 | $125.89 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $87.10 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $66.07 | $87.10 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $87.10 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $87.10 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $87.10 Typical High $114.82 | Professional | AS · PA/NP assist | $66.07 | $87.10 | $114.82 |
Where South Carolina sits
The same service costs 5.5 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 $7,406MT $1,352
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.