How much rates vary
Facilitymedian $851 · 10th to 90th $417 to $8,710Professionalmedian $389 · 10th to 90th $102 to $661
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 $489.78 Median $5,888.44 Typical High $21,877.62 | Facility | None | $489.78 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | None | $407.38 | $489.78 | $489.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $691.83 | Professional | None | $371.54 | $467.74 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $691.83 Typical High $1,174.90 | Facility | None | $100.00 | $691.83 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $741.31 | Professional | None | $398.11 | $446.68 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $1,174.90 | Facility | None | $363.08 | $489.78 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $575.44 | Professional | None | $446.68 | $478.63 | $575.44 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $323.59 Typical High $645.65 | Professional | None | $81.28 | $323.59 | $645.65 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $831.76 | Professional | None | $389.05 | $489.78 | $831.76 |
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 $204.17 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $288.40 | $338.84 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $239.88 Typical High $380.19 | Professional | 51 · Multiple procedures | $234.42 | $239.88 | $380.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $95.50 Typical High $151.36 | Professional | 80 · Assistant surgeon | $95.50 | $95.50 | $151.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $67.61 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $66.07 | $67.61 | $107.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $67.61 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $67.61 | $107.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $67.61 Typical High $107.15 | Professional | AS · PA/NP assist | $66.07 | $67.61 | $107.15 |
Where South Carolina sits
The same service costs 6.0 times more in Alaska 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· 47th of 51
$398
AK $1,380UT $229
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.