How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,738 to $20,417Professionalmedian $490 · 10th to 90th $316 to $724
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 $15,135.61 Typical High $24,547.09 | Facility | None | $549.54 | $15,135.61 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $549.54 | Professional | None | $416.87 | $549.54 | $549.54 |
BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $6,309.57 Typical High $19,498.45 | Facility | None | $1,905.46 | $6,309.57 | $19,498.45 |
BCBS Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $616.60 | Professional | None | $380.19 | $501.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,388.44 Typical High $5,495.41 | Facility | None | $602.56 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $933.25 | Professional | None | $478.63 | $478.63 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $1,737.80 Typical High $2,511.89 | Facility | None | $478.63 | $1,737.80 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $660.69 | Professional | None | $436.52 | $562.34 | $660.69 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $478.63 Typical High $724.44 | Professional | None | $66.07 | $478.63 | $724.44 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $870.96 | Professional | None | $407.38 | $501.19 | $870.96 |
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 $208.93 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $208.93 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $109.65 | $109.65 |
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 $41.69 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $41.69 | $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 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $851.14 Typical High $1,230.27 | Professional | 50 · Both sides | $660.69 | $851.14 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $281.84 Typical High $398.11 | Professional | 51 · Multiple procedures | $218.78 | $281.84 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $112.20 Typical High $158.49 | Professional | 80 · Assistant surgeon | $87.10 | $112.20 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $79.43 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $61.66 | $79.43 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $79.43 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $79.43 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $79.43 Typical High $112.20 | Professional | AS · PA/NP assist | $61.66 | $79.43 | $112.20 |
Where South Carolina sits
The same service costs 9.5 times more in Oklahoma than in Utah. 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.
South Carolina· 41st of 51
$550
OK $3,236UT $339
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.