How much rates vary
Facilitymedian $1,000 · 10th to 90th $513 to $4,786Professionalmedian $214 · 10th to 90th $155 to $447
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 $213.80 Median $5,888.44 Typical High $21,877.62 | Facility | None | $213.80 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $213.80 | Professional | None | $177.83 | $213.80 | $213.80 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $4,073.80 | Facility | None | $512.86 | $954.99 | $4,073.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $446.68 | Professional | None | $154.88 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,621.81 | Facility | None | $602.56 | $1,000.00 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $338.84 | Professional | None | $208.93 | $213.80 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $416.87 | Professional | None | $257.04 | $275.42 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $645.65 Typical High $1,122.02 | Facility | None | $213.80 | $645.65 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $524.81 | Professional | None | $204.17 | $251.19 | $524.81 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $257.04 | Professional | None | $128.82 | $162.18 | $257.04 |
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 $154.88 Median $190.55 Typical High $363.08 | Professional | None | $154.88 | $190.55 | $363.08 |
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 $89.13 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $35.48 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $131.83 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $26.30 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.78 | $21.38 | $21.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $128.82 Typical High $269.15 | Professional | 51 · Multiple procedures | $120.23 | $128.82 | $269.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $51.29 Typical High $102.33 | Professional | 80 · Assistant surgeon | $47.86 | $51.29 | $102.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $33.88 Median $35.48 Typical High $70.79 | Professional | 81 · Minimal assistant surgeon | $33.88 | $35.48 | $70.79 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $33.88 Median $35.48 Typical High $70.79 | Professional | 82 · Assistant surgeon, no resident | $33.88 | $35.48 | $70.79 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $33.88 Median $35.48 Typical High $70.79 | Professional | AS · PA/NP assist | $33.88 | $35.48 | $70.79 |
Where South Carolina sits
The same service costs 7.3 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 $4,136MT $564
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.