How much rates vary
Facilitymedian $1,778 · 10th to 90th $676 to $6,607Professionalmedian $501 · 10th to 90th $71 to $776
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 $83.18 Median $4,897.79 Typical High $21,877.62 | Facility | None | $83.18 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $436.52 Typical High $691.83 | Professional | None | $77.62 | $436.52 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
BCBS South Carolina Setting Facility Modifier None Typical Low $851.14 Median $2,041.74 Typical High $6,456.54 | Facility | None | $851.14 | $2,041.74 | $6,456.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $58.88 Median $128.82 Typical High $575.44 | Professional | None | $58.88 | $128.82 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,737.80 | Facility | None | $602.56 | $1,023.29 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $204.17 Typical High $724.44 | Professional | None | $85.11 | $204.17 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $1,479.11 | Professional | None | $114.82 | $123.03 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $758.58 Typical High $1,148.15 | Facility | None | $81.28 | $758.58 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $114.82 Median $660.69 Typical High $776.25 | Professional | None | $114.82 | $660.69 | $776.25 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $954.99 | Professional | None | $489.78 | $630.96 | $954.99 |
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 $66.07 Median $275.42 Typical High $851.14 | Professional | None | $66.07 | $275.42 | $851.14 |
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 $40.74 Median $213.80 Typical High $346.74 | Professional | 52 · Reduced service | $40.74 | $213.80 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $85.11 Typical High $138.04 | Professional | 53 · Discontinued | $16.22 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $323.59 Typical High $512.86 | Professional | 54 · Surgery only | $61.66 | $323.59 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $64.57 Typical High $102.33 | Professional | 55 · Aftercare only | $12.30 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $42.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $8.13 | $42.66 | $69.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $338.84 Typical High $416.87 | Professional | 51 · Multiple procedures | $57.54 | $338.84 | $416.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $22.91 Median $134.90 Typical High $165.96 | Professional | 80 · Assistant surgeon | $22.91 | $134.90 | $165.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.85 Median $95.50 Typical High $117.49 | Professional | 81 · Minimal assistant surgeon | $15.85 | $95.50 | $117.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.85 Median $95.50 Typical High $117.49 | Professional | 82 · Assistant surgeon, no resident | $15.85 | $95.50 | $117.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $95.50 Typical High $117.49 | Professional | AS · PA/NP assist | $15.85 | $95.50 | $117.49 |
Where South Carolina sits
The same service costs 5.6 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 $4,728MT $843
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.