How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,479 to $17,783Professionalmedian $1,380 · 10th to 90th $110 to $2,138
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 $1,548.82 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,548.82 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,584.89 | Professional | None | $1,412.54 | $1,548.82 | $1,584.89 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,698.24 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,412.54 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $4,677.35 | Facility | None | $630.96 | $3,311.31 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,479.11 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $3,801.89 | Facility | None | $1,202.26 | $1,584.89 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,621.81 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $1,202.26 Typical High $2,089.30 | Professional | None | $97.72 | $1,202.26 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,621.81 | $2,754.23 |
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 $707.95 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,511.89 Typical High $3,715.35 | Professional | 50 · Both sides | $2,137.96 | $2,511.89 | $3,715.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $831.76 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $707.95 | $831.76 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $331.13 Typical High $501.19 | Professional | 80 · Assistant surgeon | $288.40 | $331.13 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $234.42 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $199.53 | $234.42 | $346.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $234.42 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $234.42 | $346.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $346.74 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $346.74 |
Where South Carolina sits
The same service costs 3.0 times more in Alaska than in Vermont. 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
AK $12,999VT $4,294
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.