How much rates vary
Facilitymedian $2,239 · 10th to 90th $977 to $10,000Professionalmedian $617 · 10th to 90th $105 to $933
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 $645.65 Median $10,964.78 Typical High $21,877.62 | Facility | None | $645.65 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $977.24 | Professional | None | $537.03 | $645.65 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $2,884.03 Typical High $8,128.31 | Facility | None | $1,202.26 | $2,884.03 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,023.29 | Professional | None | $524.81 | $707.95 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $3,162.28 | Facility | None | $630.96 | $1,905.46 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $1,174.90 | Professional | None | $562.34 | $588.84 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $912.01 Typical High $2,398.83 | Facility | None | $575.44 | $912.01 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $776.25 | Professional | None | $616.60 | $676.08 | $776.25 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $549.54 Typical High $912.01 | Professional | None | $81.28 | $549.54 | $912.01 |
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 $501.19 Median $645.65 Typical High $1,122.02 | Professional | None | $501.19 | $645.65 | $1,122.02 |
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 $288.40 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $446.68 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $338.84 Typical High $524.81 | Professional | 51 · Multiple procedures | $309.03 | $338.84 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $134.90 Typical High $208.93 | Professional | 80 · Assistant surgeon | $123.03 | $134.90 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $87.10 Median $95.50 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $87.10 | $95.50 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $87.10 Median $95.50 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $87.10 | $95.50 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $95.50 Typical High $144.54 | Professional | AS · PA/NP assist | $87.10 | $95.50 | $144.54 |
Where South Carolina sits
The same service costs 3.6 times more in Oklahoma 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
OK $6,446MT $1,806
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.