How much rates vary
Facilitymedian $3,631 · 10th to 90th $724 to $12,589Professionalmedian $275 · 10th to 90th $166 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 $229.09 Median $10,964.78 Typical High $21,877.62 | Facility | None | $229.09 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | None | $199.53 | $229.09 | $229.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $13,182.57 | Facility | None | $1,548.82 | $4,073.80 | $13,182.57 |
BCBS South Carolina Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $512.86 | Professional | None | $165.96 | $309.03 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $1,698.24 | Facility | None | $602.56 | $977.24 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $467.74 | Professional | None | $239.88 | $346.74 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $1,778.28 Typical High $2,754.23 | Facility | None | $229.09 | $1,778.28 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $426.58 | Professional | None | $229.09 | $331.13 | $426.58 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $338.84 | Professional | None | $158.49 | $239.88 | $338.84 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $537.03 | Professional | None | $194.98 | $281.84 | $537.03 |
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 $100.00 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $100.00 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $39.81 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $147.91 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $29.51 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.95 | $22.91 | $22.91 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $190.55 Typical High $208.93 | Professional | 51 · Multiple procedures | $131.83 | $190.55 | $208.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $70.79 Typical High $85.11 | Professional | 80 · Assistant surgeon | $52.48 | $70.79 | $85.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $50.12 Typical High $58.88 | Professional | 81 · Minimal assistant surgeon | $37.15 | $50.12 | $58.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $50.12 Typical High $58.88 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $50.12 | $58.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $50.12 Typical High $58.88 | Professional | AS · PA/NP assist | $37.15 | $50.12 | $58.88 |
Where South Carolina sits
The same service costs 7.6 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 $4,681MT $618
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.