How much rates vary
Facilitymedian $8,913 · 10th to 90th $501 to $34,674Professionalmedian $339 · 10th to 90th $83 to $468
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 $371.54 Median $5,623.41 Typical High $21,877.62 | Facility | None | $371.54 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | None | $309.03 | $371.54 | $371.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $8,912.51 Typical High $35,481.34 | Facility | None | $512.86 | $8,912.51 | $35,481.34 |
BCBS South Carolina Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $457.09 | Professional | None | $302.00 | $363.08 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $14,791.08 Typical High $24,547.09 | Facility | None | $457.09 | $14,791.08 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $562.34 | Professional | None | $338.84 | $338.84 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $501.19 Typical High $7,413.10 | Facility | None | $338.84 | $501.19 | $7,413.10 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $446.68 | Professional | None | $354.81 | $407.38 | $446.68 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $275.42 Typical High $436.52 | Professional | None | $72.44 | $275.42 | $436.52 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $10,471.29 Typical High $39,810.72 | Facility | None | $3,311.31 | $10,471.29 | $39,810.72 |
United Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $524.81 | Professional | None | $251.19 | $323.59 | $524.81 |
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 $154.88 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $61.66 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $46.77 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.90 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $257.04 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $213.80 | $257.04 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $223.87 Typical High $275.42 | Professional | 51 · Multiple procedures | $181.97 | $223.87 | $275.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $89.13 Typical High $112.20 | Professional | 80 · Assistant surgeon | $72.44 | $89.13 | $112.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $61.66 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $51.29 | $61.66 | $77.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $61.66 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $61.66 | $77.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $61.66 Typical High $77.62 | Professional | AS · PA/NP assist | $51.29 | $61.66 | $77.62 |
Where South Carolina sits
The same service costs 29.1 times more in Alabama 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
AL $30,626MT $1,051
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.