How much rates vary
Facilitymedian $1,259 · 10th to 90th $501 to $8,913Professionalmedian $398 · 10th to 90th $89 to $575
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 $426.58 Median $5,623.41 Typical High $21,877.62 | Facility | None | $426.58 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $426.58 | Professional | None | $346.74 | $426.58 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $7,585.78 | Facility | None | $512.86 | $1,148.15 | $7,585.78 |
BCBS South Carolina Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $676.08 | Professional | None | $354.81 | $537.03 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,023.29 Typical High $1,479.11 | Facility | None | $457.09 | $1,023.29 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $676.08 | Professional | None | $363.08 | $371.54 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $501.19 Typical High $1,288.25 | Facility | None | $407.38 | $501.19 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $602.56 | Professional | None | $407.38 | $457.09 | $602.56 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $363.08 Typical High $562.34 | Professional | None | $77.62 | $363.08 | $562.34 |
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 $295.12 Median $371.54 Typical High $602.56 | Professional | None | $295.12 | $371.54 | $602.56 |
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 $177.83 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $177.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $245.47 | $302.00 | $302.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $257.04 Typical High $338.84 | Professional | 51 · Multiple procedures | $204.17 | $257.04 | $338.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $102.33 Typical High $134.90 | Professional | 80 · Assistant surgeon | $81.28 | $102.33 | $134.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $70.79 Typical High $95.50 | Professional | 81 · Minimal assistant surgeon | $57.54 | $70.79 | $95.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $70.79 Typical High $95.50 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $70.79 | $95.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $70.79 Typical High $95.50 | Professional | AS · PA/NP assist | $57.54 | $70.79 | $95.50 |
Where South Carolina sits
The same service costs 4.0 times more in Colorado 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
CO $4,866MT $1,221
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.