How much rates vary
Facilitymedian $178 · 10th to 90th $78 to $1,738Professionalmedian $195 · 10th to 90th $102 to $269
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 $112.20 Median $4,897.79 Typical High $21,877.62 | Facility | None | $112.20 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $245.47 | Professional | None | $112.20 | $154.88 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $128.82 Typical High $151.36 | Professional | None | $75.86 | $128.82 | $151.36 |
BCBS South Carolina Setting Facility Modifier None Typical Low $102.33 Median $181.97 Typical High $309.03 | Facility | None | $102.33 | $181.97 | $309.03 |
BCBS South Carolina Setting Professional Modifier None Typical Low $85.11 Median $204.17 Typical High $239.88 | Professional | None | $85.11 | $204.17 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $794.33 | Facility | None | $52.48 | $77.62 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $281.84 | Professional | None | $173.78 | $223.87 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $112.20 Typical High $208.93 | Facility | None | $30.20 | $112.20 | $208.93 |
Medcost Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $281.84 | Professional | None | $162.18 | $223.87 | $281.84 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $229.09 | Professional | None | $128.82 | $158.49 | $229.09 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $316.23 | Professional | None | $93.33 | $151.36 | $316.23 |
10 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 $56.23 Median $69.18 Typical High $77.62 | Professional | 52 · Reduced service | $56.23 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.18 Typical High $30.90 | Professional | 53 · Discontinued | $22.39 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $104.71 Typical High $114.82 | Professional | 54 · Surgery only | $85.11 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.89 Typical High $22.91 | Professional | 55 · Aftercare only | $16.98 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.80 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.22 | $13.80 | $15.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $112.20 Typical High $141.25 | Professional | 51 · Multiple procedures | $102.33 | $112.20 | $141.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $44.67 Typical High $56.23 | Professional | 80 · Assistant surgeon | $40.74 | $44.67 | $56.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.18 Median $30.90 Typical High $39.81 | Professional | 81 · Minimal assistant surgeon | $28.18 | $30.90 | $39.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.18 Median $30.90 Typical High $39.81 | Professional | 82 · Assistant surgeon, no resident | $28.18 | $30.90 | $39.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $30.90 Typical High $39.81 | Professional | AS · PA/NP assist | $28.18 | $30.90 | $39.81 |
Where South Carolina sits
The same service costs 11.5 times more in Connecticut than in Maryland. 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
CT $2,992MD $261
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.