How much rates vary
Facilitymedian $3,388 · 10th to 90th $214 to $14,125Professionalmedian $245 · 10th to 90th $141 to $1,175
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 $194.98 Median $8,709.64 Typical High $21,877.62 | Facility | None | $194.98 | $8,709.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $616.60 | Professional | None | $194.98 | $194.98 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $19.50 Median $147.91 Typical High $1,096.48 | Professional | None | $19.50 | $147.91 | $1,096.48 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $3,890.45 Typical High $15,135.61 | Facility | None | $1,621.81 | $3,890.45 | $15,135.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $141.25 Median $1,071.52 Typical High $1,479.11 | Professional | None | $141.25 | $1,071.52 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $794.33 Typical High $2,089.30 | Facility | None | $602.56 | $794.33 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $776.25 Typical High $851.14 | Professional | None | $218.78 | $776.25 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $645.65 Typical High $1,905.46 | Facility | None | $194.98 | $645.65 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $194.98 Median $812.83 Typical High $1,202.26 | Professional | None | $194.98 | $812.83 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $288.40 | Professional | None | $158.49 | $204.17 | $288.40 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,344.23 | Facility | None | $83.18 | $426.58 | $2,344.23 |
United Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $954.99 | Professional | None | $144.54 | $208.93 | $954.99 |
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 $85.11 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $33.88 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 54 · Surgery only | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $25.12 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.98 | $19.50 | $19.50 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $1,230.27 Typical High $1,819.70 | Professional | 50 · Both sides | $371.54 | $1,230.27 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $407.38 Typical High $602.56 | Professional | 51 · Multiple procedures | $123.03 | $407.38 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $162.18 Typical High $239.88 | Professional | 80 · Assistant surgeon | $48.98 | $162.18 | $239.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $114.82 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $34.67 | $114.82 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $114.82 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $114.82 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $114.82 Typical High $169.82 | Professional | AS · PA/NP assist | $34.67 | $114.82 | $169.82 |
Where South Carolina sits
The same service costs 12.8 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 $6,759MT $526
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.