How much rates vary
Facilitymedian $3,890 · 10th to 90th $933 to $13,804Professionalmedian $372 · 10th to 90th $234 to $708
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 $316.23 Median $10,964.78 Typical High $21,877.62 | Facility | None | $316.23 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $389.05 | Professional | None | $275.42 | $316.23 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $213.80 | Professional | None | $28.84 | $28.84 | $213.80 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,047.13 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,047.13 | $4,365.16 | $12,589.25 |
BCBS South Carolina Setting Professional Modifier None Typical Low $234.42 Median $616.60 Typical High $741.31 | Professional | None | $234.42 | $616.60 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $5,623.41 | Facility | None | $630.96 | $2,951.21 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $691.83 Typical High $707.95 | Professional | None | $354.81 | $691.83 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $338.84 Median $812.83 Typical High $4,365.16 | Facility | None | $338.84 | $812.83 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $851.14 | Professional | None | $316.23 | $446.68 | $851.14 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $407.38 | Professional | None | $223.87 | $281.84 | $407.38 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $19,498.45 | Facility | None | $1,023.29 | $3,311.31 | $19,498.45 |
United Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $794.33 | Professional | None | $234.42 | $316.23 | $794.33 |
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 $134.90 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $204.17 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $40.74 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.92 | $31.62 | $31.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $263.03 Typical High $426.58 | Professional | 51 · Multiple procedures | $194.98 | $263.03 | $426.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $104.71 Typical High $169.82 | Professional | 80 · Assistant surgeon | $79.43 | $104.71 | $169.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $72.44 Typical High $117.49 | Professional | 81 · Minimal assistant surgeon | $54.95 | $72.44 | $117.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $72.44 Typical High $117.49 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $72.44 | $117.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $72.44 Typical High $117.49 | Professional | AS · PA/NP assist | $54.95 | $72.44 | $117.49 |
Where South Carolina sits
The same service costs 13.6 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 $11,880MT $873
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.