How much rates vary
Facilitymedian $1,288 · 10th to 90th $110 to $2,570Professionalmedian $93 · 10th to 90th $74 to $151
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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | None (both parts) | $77.62 | $91.20 | $91.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $776.25 Median $1,513.56 Typical High $2,754.23 | Facility | None | $776.25 | $1,513.56 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $524.81 Typical High $870.96 | Facility | None | $436.52 | $524.81 | $870.96 |
Cigna Setting Professional Modifier None (both parts) Typical Low $91.20 Median $97.72 Typical High $177.83 | Professional | None (both parts) | $91.20 | $97.72 | $177.83 |
Medcost Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $446.68 | Facility | None | $58.88 | $91.20 | $446.68 |
Medcost Setting Professional Modifier None (both parts) Typical Low $91.20 Median $107.15 Typical High $123.03 | Professional | None (both parts) | $91.20 | $107.15 | $123.03 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None (both parts) | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,344.23 | Facility | None | $83.18 | $446.68 | $2,344.23 |
United Setting Professional Modifier None (both parts) Typical Low $75.86 Median $100.00 Typical High $165.96 | Professional | None (both parts) | $75.86 | $100.00 | $165.96 |
12 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 $38.90 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $38.90 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $15.49 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $11.48 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.76 | $9.12 | $9.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $37.15 Median $45.71 Typical High $56.23 | Professional | 26 · Professional part | $37.15 | $45.71 | $56.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $173.78 Typical High $213.80 | Professional | 50 · Both sides | $141.25 | $173.78 | $213.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $46.77 Median $57.54 Typical High $70.79 | Professional | 51 · Multiple procedures | $46.77 | $57.54 | $70.79 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $22.91 Typical High $28.18 | Professional | 80 · Assistant surgeon | $18.62 | $22.91 | $28.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $16.22 Typical High $19.95 | Professional | 81 · Minimal assistant surgeon | $13.18 | $16.22 | $19.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $16.22 Typical High $19.95 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $16.22 | $19.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $13.18 Median $16.22 Typical High $19.95 | Professional | AS · PA/NP assist | $13.18 | $16.22 | $19.95 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $56.23 Median $69.18 Typical High $85.11 | Professional | TC · Technical part | $56.23 | $69.18 | $85.11 |
Where South Carolina sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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.
South Carolina· 21st of 51
$129
AK $316KY $70.79
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.