How much rates vary
Facilitymedian $1,288 · 10th to 90th $110 to $2,570Professionalmedian $15 · 10th to 90th $12 to $30
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 $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None (both parts) Typical Low $11.75 Median $13.80 Typical High $13.80 | Professional | None (both parts) | $11.75 | $13.80 | $13.80 |
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 $14.79 Median $15.49 Typical High $33.88 | Professional | None (both parts) | $14.79 | $15.49 | $33.88 |
Medcost Setting Facility Modifier None Typical Low $13.80 Median $18.62 Typical High $446.68 | Facility | None | $13.80 | $18.62 | $446.68 |
Medcost Setting Professional Modifier None (both parts) Typical Low $13.80 Median $15.85 Typical High $18.62 | Professional | None (both parts) | $13.80 | $15.85 | $18.62 |
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 $11.75 Median $15.14 Typical High $25.12 | Professional | None (both parts) | $11.75 | $15.14 | $25.12 |
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 $5.89 Median $6.92 Typical High $6.92 | Professional | 52 · Reduced service | $5.89 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.75 Typical High $2.75 | Professional | 53 · Discontinued | $2.34 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $2.04 Typical High $2.04 | Professional | 55 · Aftercare only | $1.78 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.38 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.17 | $1.38 | $1.38 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $5.89 Median $7.08 Typical High $8.51 | Professional | 26 · Professional part | $5.89 | $7.08 | $8.51 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $21.88 Median $26.30 Typical High $31.62 | Professional | 50 · Both sides | $21.88 | $26.30 | $31.62 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $7.24 Median $8.71 Typical High $10.72 | Professional | 51 · Multiple procedures | $7.24 | $8.71 | $10.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.95 Median $3.55 Typical High $4.27 | Professional | 80 · Assistant surgeon | $2.95 | $3.55 | $4.27 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $2.04 Median $2.45 Typical High $2.95 | Professional | 81 · Minimal assistant surgeon | $2.04 | $2.45 | $2.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $2.04 Median $2.45 Typical High $2.95 | Professional | 82 · Assistant surgeon, no resident | $2.04 | $2.45 | $2.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $2.04 Median $2.45 Typical High $2.95 | Professional | AS · PA/NP assist | $2.04 | $2.45 | $2.95 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $8.71 Median $10.47 Typical High $12.59 | Professional | TC · Technical part | $8.71 | $10.47 | $12.59 |
Where South Carolina sits
The same service costs 12.3 times more in Florida 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· 6th of 51
$30.20
FL $132KY $10.72
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.