How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | None (both parts) | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | 26 · Professional part | $154.88 | $154.88 | $158.49 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | None (both parts) | $199.53 | $199.53 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $1,230.27 | Facility | None | $380.19 | $512.86 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $186.21 Typical High $575.44 | Facility | None | $154.88 | $186.21 | $575.44 |
Medcost Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $281.84 | Professional | None (both parts) | $199.53 | $199.53 | $281.84 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $79.43 Median $79.43 Typical High $141.25 | Professional | 26 · Professional part | $79.43 | $79.43 | $141.25 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $239.88 | Facility | None | $181.97 | $181.97 | $239.88 |
United Setting Professional Modifier None (both parts) Typical Low $83.18 Median $120.23 Typical High $199.53 | Professional | None (both parts) | $83.18 | $120.23 | $199.53 |
9 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 $77.62 Median $77.62 Typical High $79.43 | Professional | 52 · Reduced service | $77.62 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | 53 · Discontinued | $30.90 | $30.90 | $32.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $302.00 Typical High $478.63 | Professional | 50 · Both sides | $302.00 | $302.00 | $478.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $100.00 Typical High $158.49 | Professional | 51 · Multiple procedures | $100.00 | $100.00 | $158.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $39.81 Typical High $64.57 | Professional | 80 · Assistant surgeon | $39.81 | $39.81 | $64.57 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $28.18 Typical High $44.67 | Professional | 81 · Minimal assistant surgeon | $28.18 | $28.18 | $44.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.18 Median $28.18 Typical High $44.67 | Professional | 82 · Assistant surgeon, no resident | $28.18 | $28.18 | $44.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $28.18 Typical High $44.67 | Professional | AS · PA/NP assist | $28.18 | $28.18 | $44.67 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $181.97 Median $181.97 Typical High $316.23 | Professional | TC · Technical part | $181.97 | $181.97 | $316.23 |
Where South Carolina sits
The same service costs 16.2 times more in Alaska than in Ohio. 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· 22nd of 51
$200
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.