How much rates vary
Facilitymedian $871 · 10th to 90th $468 to $3,020Professionalmedian $162 · 10th to 90th $69 to $288
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 $87.10 Median $223.87 Typical High $10,000.00 | Facility | None | $87.10 | $223.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $204.17 | Professional | None | $81.28 | $158.49 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $112.20 | Professional | None | $51.29 | $60.26 | $112.20 |
BCBS South Carolina Setting Facility Modifier None Typical Low $575.44 Median $870.96 Typical High $1,348.96 | Facility | None | $575.44 | $870.96 | $1,348.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $165.96 | Professional | None | $60.26 | $97.72 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,380.38 Typical High $1,905.46 | Facility | None | $549.54 | $1,380.38 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $194.98 Typical High $323.59 | Professional | None | $100.00 | $194.98 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $199.53 Typical High $1,071.52 | Facility | None | $87.10 | $199.53 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $245.47 | Professional | None | $169.82 | $223.87 | $245.47 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $316.23 | Professional | None | $158.49 | $229.09 | $316.23 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $77.62 Median $162.18 Typical High $302.00 | Professional | None | $77.62 | $162.18 | $302.00 |
11 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 $40.74 Median $48.98 Typical High $100.00 | Professional | 52 · Reduced service | $40.74 | $48.98 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.95 Typical High $39.81 | Professional | 53 · Discontinued | $16.60 | $19.95 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $74.13 Typical High $147.91 | Professional | 54 · Surgery only | $64.57 | $74.13 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $14.79 Typical High $29.51 | Professional | 55 · Aftercare only | $12.30 | $14.79 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.77 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.32 | $9.77 | $19.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $338.84 Typical High $457.09 | Professional | 50 · Both sides | $331.13 | $338.84 | $457.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $109.65 Median $112.20 Typical High $154.88 | Professional | 51 · Multiple procedures | $109.65 | $112.20 | $154.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $44.67 Typical High $61.66 | Professional | 80 · Assistant surgeon | $43.65 | $44.67 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.90 Median $31.62 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $30.90 | $31.62 | $42.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.90 Median $31.62 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $30.90 | $31.62 | $42.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $31.62 Typical High $42.66 | Professional | AS · PA/NP assist | $30.90 | $31.62 | $42.66 |
Where South Carolina sits
The same service costs 9.7 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 $4,351MT $447
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.