How much rates vary
Facilitymedian $1,288 · 10th to 90th $110 to $2,570Professionalmedian $58 · 10th to 90th $45 to $91
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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None (both parts) Typical Low $46.77 Median $54.95 Typical High $54.95 | Professional | None (both parts) | $46.77 | $54.95 | $54.95 |
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 $57.54 Median $60.26 Typical High $107.15 | Professional | None (both parts) | $57.54 | $60.26 | $107.15 |
Medcost Setting Facility Modifier None Typical Low $53.70 Median $58.88 Typical High $446.68 | Facility | None | $53.70 | $58.88 | $446.68 |
Medcost Setting Professional Modifier None (both parts) Typical Low $54.95 Median $63.10 Typical High $72.44 | Professional | None (both parts) | $54.95 | $63.10 | $72.44 |
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 $45.71 Median $58.88 Typical High $100.00 | Professional | None (both parts) | $45.71 | $58.88 | $100.00 |
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 $23.44 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $23.44 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $9.33 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.08 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.68 | $5.50 | $5.50 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $22.39 Median $27.54 Typical High $33.88 | Professional | 26 · Professional part | $22.39 | $27.54 | $33.88 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $85.11 Median $104.71 Typical High $125.89 | Professional | 50 · Both sides | $85.11 | $104.71 | $125.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $28.18 Median $34.67 Typical High $42.66 | Professional | 51 · Multiple procedures | $28.18 | $34.67 | $42.66 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $11.22 Median $13.80 Typical High $16.98 | Professional | 80 · Assistant surgeon | $11.22 | $13.80 | $16.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.94 Median $9.77 Typical High $11.75 | Professional | 81 · Minimal assistant surgeon | $7.94 | $9.77 | $11.75 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.94 Median $9.77 Typical High $11.75 | Professional | 82 · Assistant surgeon, no resident | $7.94 | $9.77 | $11.75 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $7.94 Median $9.77 Typical High $11.75 | Professional | AS · PA/NP assist | $7.94 | $9.77 | $11.75 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $41.69 Typical High $51.29 | Professional | TC · Technical part | $33.88 | $41.69 | $51.29 |
Where South Carolina sits
The same service costs 4.7 times more in Wisconsin 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· 15th of 51
$87.10
WI $200KY $42.66
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.