How much rates vary
Facilitymedian $575 · 10th to 90th $135 to $4,898Professionalmedian $363 · 10th to 90th $85 to $676
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 $93.33 Median $407.38 Typical High $10,000.00 | Facility | None | $93.33 | $407.38 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $302.00 Typical High $426.58 | Professional | None | $93.33 | $302.00 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $128.82 | Professional | None | $63.10 | $77.62 | $128.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $97.72 Median $575.44 Typical High $891.25 | Facility | None | $97.72 | $575.44 | $891.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $70.79 Median $190.55 Typical High $446.68 | Professional | None | $70.79 | $190.55 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $575.44 Typical High $891.25 | Facility | None | $457.09 | $575.44 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $346.74 Typical High $676.08 | Professional | None | $109.65 | $346.74 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $89.13 Median $389.05 Typical High $660.69 | Facility | None | $89.13 | $389.05 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $691.83 | Professional | None | $416.87 | $602.56 | $691.83 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $691.83 | Professional | None | $346.74 | $501.19 | $691.83 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,025.60 | Facility | None | $302.00 | $1,122.02 | $6,025.60 |
United Setting Professional Modifier None Typical Low $85.11 Median $331.13 Typical High $812.83 | Professional | None | $85.11 | $331.13 | $812.83 |
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 $42.66 Median $47.86 Typical High $199.53 | Professional | 52 · Reduced service | $42.66 | $47.86 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.05 Typical High $79.43 | Professional | 53 · Discontinued | $16.98 | $19.05 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $70.79 Typical High $302.00 | Professional | 54 · Surgery only | $69.18 | $70.79 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $60.26 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.55 Typical High $39.81 | Professional | 56 · Pre-op care only | $8.51 | $9.55 | $39.81 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $912.01 Typical High $1,047.13 | Professional | 50 · Both sides | $707.95 | $912.01 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $302.00 Typical High $416.87 | Professional | 51 · Multiple procedures | $263.03 | $302.00 | $416.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $120.23 Typical High $186.21 | Professional | 80 · Assistant surgeon | $95.50 | $120.23 | $186.21 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $85.11 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $66.07 | $85.11 | $128.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $85.11 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $85.11 | $128.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $85.11 Typical High $128.82 | Professional | AS · PA/NP assist | $66.07 | $85.11 | $128.82 |
Where South Carolina sits
The same service costs 5.5 times more in Connecticut 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
CT $3,114MT $570
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.