How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,660 to $15,849Professionalmedian $339 · 10th to 90th $229 to $468
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 $302.00 Median $10,000.00 Typical High $21,877.62 | Facility | None | $302.00 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $302.00 | Professional | None | $251.19 | $302.00 | $302.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $4,677.35 Typical High $13,803.84 | Facility | None | $1,905.46 | $4,677.35 | $13,803.84 |
BCBS South Carolina Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $524.81 | Professional | None | $229.09 | $407.38 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,388.44 Typical High $5,495.41 | Facility | None | $602.56 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $562.34 | Professional | None | $309.03 | $331.13 | $562.34 |
Medcost Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $691.83 | Facility | None | $269.15 | $302.00 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $371.54 | Professional | None | $288.40 | $338.84 | $371.54 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $457.09 | Professional | None | $223.87 | $331.13 | $457.09 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $549.54 | Professional | None | $245.47 | $316.23 | $549.54 |
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 $123.03 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $50.12 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $37.15 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.12 | $30.20 | $30.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $169.82 Typical High $234.42 | Professional | 51 · Multiple procedures | $165.96 | $169.82 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $67.61 Typical High $89.13 | Professional | 80 · Assistant surgeon | $66.07 | $67.61 | $89.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $46.77 Median $47.86 Typical High $63.10 | Professional | 81 · Minimal assistant surgeon | $46.77 | $47.86 | $63.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $46.77 Median $47.86 Typical High $63.10 | Professional | 82 · Assistant surgeon, no resident | $46.77 | $47.86 | $63.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $47.86 Typical High $63.10 | Professional | AS · PA/NP assist | $46.77 | $47.86 | $63.10 |
Where South Carolina sits
The same service costs 13.0 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 $10,613MT $815
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.