How much rates vary
Facilitymedian $1,202 · 10th to 90th $60 to $6,918Professionalmedian $158 · 10th to 90th $40 to $275
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 $44.67 Median $4,897.79 Typical High $21,877.62 | Facility | None | $44.67 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $117.49 Typical High $213.80 | Professional | None | $37.15 | $117.49 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
BCBS South Carolina Setting Professional Modifier None Typical Low $31.62 Median $67.61 Typical High $165.96 | Professional | None | $31.62 | $67.61 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $97.72 Typical High $269.15 | Professional | None | $44.67 | $97.72 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $100.00 Typical High $288.40 | Facility | None | $43.65 | $100.00 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $64.57 Median $186.21 Typical High $239.88 | Professional | None | $64.57 | $186.21 | $239.88 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $309.03 | Professional | None | $165.96 | $218.78 | $309.03 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $2,951.21 | Facility | None | $446.68 | $1,621.81 | $2,951.21 |
United Setting Professional Modifier None Typical Low $38.02 Median $109.65 Typical High $275.42 | Professional | None | $38.02 | $109.65 | $275.42 |
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 $21.38 Median $58.88 Typical High $107.15 | Professional | 52 · Reduced service | $21.38 | $58.88 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $30.90 Typical High $42.66 | Professional | 53 · Discontinued | $8.71 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $114.82 Typical High $158.49 | Professional | 54 · Surgery only | $32.36 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $22.91 Typical High $31.62 | Professional | 55 · Aftercare only | $6.46 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $15.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $4.37 | $15.49 | $21.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $93.33 Typical High $158.49 | Professional | 51 · Multiple procedures | $32.36 | $93.33 | $158.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.88 Median $38.02 Typical High $64.57 | Professional | 80 · Assistant surgeon | $12.88 | $38.02 | $64.57 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $8.91 Median $26.30 Typical High $44.67 | Professional | 81 · Minimal assistant surgeon | $8.91 | $26.30 | $44.67 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $8.91 Median $26.30 Typical High $44.67 | Professional | 82 · Assistant surgeon, no resident | $8.91 | $26.30 | $44.67 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $8.91 Median $26.30 Typical High $44.67 | Professional | AS · PA/NP assist | $8.91 | $26.30 | $44.67 |
Where South Carolina sits
The same service costs 4.5 times more in Wisconsin 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· 21st of 51
$158
WI $251MI $56.23
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.