How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,862 to $20,417Professionalmedian $1,122 · 10th to 90th $170 to $1,778
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 $1,288.25 Median $9,772.37 Typical High $21,877.62 | Facility | None | $1,288.25 | $9,772.37 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,288.25 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,137.96 Median $6,456.54 Typical High $19,952.62 | Facility | None | $2,137.96 | $6,456.54 | $19,952.62 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,548.82 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $7,244.36 | Facility | None | $602.56 | $4,265.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,258.93 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $4,677.35 | Facility | None | $1,288.25 | $2,290.87 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,479.11 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $912.01 Typical High $1,548.82 | Professional | None | $154.88 | $912.01 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $7,585.78 Typical High $22,908.68 | Facility | None | $1,819.70 | $7,585.78 | $22,908.68 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,905.46 | Professional | None | $933.25 | $1,202.26 | $1,905.46 |
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 $562.34 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $891.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,344.23 Typical High $3,890.45 | Professional | 50 · Both sides | $2,041.74 | $2,344.23 | $3,890.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $776.25 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $676.08 | $776.25 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $309.03 Typical High $524.81 | Professional | 80 · Assistant surgeon | $275.42 | $309.03 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $218.78 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $190.55 | $218.78 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $218.78 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $218.78 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $218.78 Typical High $363.08 | Professional | AS · PA/NP assist | $190.55 | $218.78 | $363.08 |
Where South Carolina sits
The same service costs 5.0 times more in Colorado than in Kentucky. 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 $14,731KY $2,968
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.