How much rates vary
Facilitymedian $1,096 · 10th to 90th $617 to $4,786Professionalmedian $447 · 10th to 90th $324 to $676
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 $446.68 Median $5,888.44 Typical High $21,877.62 | Facility | None | $446.68 | $5,888.44 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $446.68 | Professional | None | $380.19 | $446.68 | $446.68 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,202.26 Typical High $4,073.80 | Facility | None | $691.83 | $1,202.26 | $4,073.80 |
BCBS South Carolina Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $676.08 | Professional | None | $323.59 | $524.81 | $676.08 |
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 $436.52 Median $446.68 Typical High $660.69 | Professional | None | $436.52 | $446.68 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $870.96 | Professional | None | $537.03 | $575.44 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $1,122.02 | Facility | None | $446.68 | $676.08 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $758.58 | Professional | None | $436.52 | $524.81 | $758.58 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $630.96 | Professional | None | $316.23 | $407.38 | $630.96 |
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 $331.13 Median $398.11 Typical High $758.58 | Professional | None | $331.13 | $398.11 | $758.58 |
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 $186.21 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $75.86 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $56.23 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $44.67 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $269.15 Typical High $389.05 | Professional | 51 · Multiple procedures | $245.47 | $269.15 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $107.15 Typical High $154.88 | Professional | 80 · Assistant surgeon | $97.72 | $107.15 | $154.88 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $75.86 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $69.18 | $75.86 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $75.86 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $75.86 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $75.86 Typical High $109.65 | Professional | AS · PA/NP assist | $69.18 | $75.86 | $109.65 |
Where South Carolina sits
The same service costs 3.8 times more in Colorado than in Delaware. 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 $4,403DE $1,156
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.