How much rates vary
Facilitymedian $468 · 10th to 90th $102 to $1,413Professionalmedian $209 · 10th to 90th $141 to $339
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 $154.88 Median $154.88 Typical High $251.19 | Facility | None | $154.88 | $154.88 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $251.19 | Professional | None | $151.36 | $186.21 | $251.19 |
BCBS South Carolina Setting Facility Modifier None Typical Low $371.54 Median $660.69 Typical High $1,122.02 | Facility | None | $371.54 | $660.69 | $1,122.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $251.19 | Professional | None | $125.89 | $158.49 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $173.78 Typical High $281.84 | Facility | None | $75.86 | $173.78 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $338.84 | Professional | None | $151.36 | $223.87 | $338.84 |
Medcost Setting Facility Modifier None Typical Low $117.49 Median $181.97 Typical High $281.84 | Facility | None | $117.49 | $181.97 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $295.12 | Professional | None | $208.93 | $251.19 | $295.12 |
Molina Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $457.09 | Professional | None | $257.04 | $316.23 | $457.09 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $316.23 | Professional | None | $117.49 | $190.55 | $316.23 |
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 $93.33 Typical High $125.89 | Professional | 52 · Reduced service | $77.62 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $37.15 Typical High $50.12 | Professional | 53 · Discontinued | $30.90 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.18 Typical High $38.02 | Professional | 55 · Aftercare only | $23.44 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.62 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.49 | $18.62 | $25.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $131.83 Typical High $194.98 | Professional | 51 · Multiple procedures | $107.15 | $131.83 | $194.98 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $52.48 Typical High $77.62 | Professional | 80 · Assistant surgeon | $42.66 | $52.48 | $77.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $29.51 Median $37.15 Typical High $54.95 | Professional | 81 · Minimal assistant surgeon | $29.51 | $37.15 | $54.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $29.51 Median $37.15 Typical High $54.95 | Professional | 82 · Assistant surgeon, no resident | $29.51 | $37.15 | $54.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $29.51 Median $37.15 Typical High $54.95 | Professional | AS · PA/NP assist | $29.51 | $37.15 | $54.95 |
Where South Carolina sits
The same service costs 8.0 times more in New York 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
NY $2,495MD $313
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.