How much rates vary
Facilitymedian $1,738 · 10th to 90th $661 to $9,550Professionalmedian $170 · 10th to 90th $110 to $263
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 $173.78 Median $5,888.44 Typical High $21,877.62 | Facility | None | $173.78 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | None | $138.04 | $173.78 | $173.78 |
BCBS South Carolina Setting Facility Modifier None Typical Low $676.08 Median $1,698.24 Typical High $8,128.31 | Facility | None | $676.08 | $1,698.24 | $8,128.31 |
BCBS South Carolina Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $316.23 | Professional | None | $120.23 | $194.98 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,570.40 | Facility | None | $602.56 | $1,862.09 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $309.03 | Professional | None | $151.36 | $173.78 | $309.03 |
Medcost Setting Facility Modifier None Typical Low $165.96 Median $645.65 Typical High $1,479.11 | Facility | None | $165.96 | $645.65 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $346.74 | Professional | None | $165.96 | $208.93 | $346.74 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $190.55 | Professional | None | $100.00 | $134.90 | $190.55 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $288.40 | Professional | None | $134.90 | $173.78 | $288.40 |
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 $69.18 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $69.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $28.18 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $20.89 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.80 | $17.38 | $17.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $112.20 Typical High $173.78 | Professional | 51 · Multiple procedures | $89.13 | $112.20 | $173.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $44.67 Typical High $69.18 | Professional | 80 · Assistant surgeon | $35.48 | $44.67 | $69.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.12 Median $31.62 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $25.12 | $31.62 | $47.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.12 Median $31.62 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $25.12 | $31.62 | $47.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $25.12 Median $31.62 Typical High $47.86 | Professional | AS · PA/NP assist | $25.12 | $31.62 | $47.86 |
Where South Carolina sits
The same service costs 14.3 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 $6,102MT $428
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.