How much rates vary
Facilitymedian $4,898 · 10th to 90th $117 to $9,772Professionalmedian $107 · 10th to 90th $62 to $174
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 $85.11 Median $4,897.79 Typical High $21,877.62 | Facility | None | $85.11 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | None (both parts) | $85.11 | $85.11 | $131.83 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $61.66 Median $70.79 Typical High $75.86 | Professional | None (both parts) | $61.66 | $70.79 | $75.86 |
Cigna Setting Professional Modifier None (both parts) Typical Low $83.18 Median $125.89 Typical High $194.98 | Professional | None (both parts) | $83.18 | $125.89 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $117.49 Typical High $194.98 | Facility | None | $85.11 | $117.49 | $194.98 |
Medcost Setting Professional Modifier None (both parts) Typical Low $128.82 Median $151.36 Typical High $154.88 | Professional | None (both parts) | $128.82 | $151.36 | $154.88 |
Molina Setting Professional Modifier None (both parts) Typical Low $38.02 Median $58.88 Typical High $95.50 | Professional | None (both parts) | $38.02 | $58.88 | $95.50 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $6,309.57 Typical High $9,332.54 | Facility | None | $3,019.95 | $6,309.57 | $9,332.54 |
United Setting Professional Modifier None (both parts) Typical Low $69.18 Median $114.82 Typical High $204.17 | Professional | None (both parts) | $69.18 | $114.82 | $204.17 |
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 $42.66 Median $42.66 Typical High $66.07 | Professional | 52 · Reduced service | $42.66 | $42.66 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $26.30 | Professional | 53 · Discontinued | $17.38 | $17.38 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $19.95 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $13.18 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | 26 · Professional part | $60.26 | $60.26 | $74.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | 50 · Both sides | $229.09 | $229.09 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | 51 · Multiple procedures | $75.86 | $75.86 | $79.43 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $30.20 Typical High $32.36 | Professional | 80 · Assistant surgeon | $30.20 | $30.20 | $32.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 81 · Minimal assistant surgeon | $21.38 | $21.38 | $22.39 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 82 · Assistant surgeon, no resident | $21.38 | $21.38 | $22.39 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | AS · PA/NP assist | $21.38 | $21.38 | $22.39 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | TC · Technical part | $91.20 | $91.20 | $112.20 |
Where South Carolina sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 40th of 51
$126
OK $832MI $95.50
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.