How much rates vary
Facilitymedian $1,259 · 10th to 90th $490 to $10,233Professionalmedian $162 · 10th to 90th $100 to $263
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 $125.89 Median $4,897.79 Typical High $21,877.62 | Facility | None | $125.89 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $245.47 | Professional | None | $117.49 | $158.49 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $147.91 | Professional | None | $89.13 | $128.82 | $147.91 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $1,258.93 Typical High $9,549.93 | Facility | None | $512.86 | $1,258.93 | $9,549.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $263.03 | Professional | None | $81.28 | $144.54 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,096.48 Typical High $1,548.82 | Facility | None | $457.09 | $1,096.48 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $302.00 | Professional | None | $114.82 | $190.55 | $302.00 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $436.52 Typical High $1,096.48 | Facility | None | $125.89 | $436.52 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $302.00 | Professional | None | $138.04 | $213.80 | $302.00 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $251.19 | Professional | None | $128.82 | $181.97 | $251.19 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $323.59 | Professional | None | $97.72 | $158.49 | $323.59 |
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 $60.26 Median $69.18 Typical High $95.50 | Professional | 52 · Reduced service | $60.26 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $27.54 Typical High $38.02 | Professional | 53 · Discontinued | $23.99 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $102.33 Typical High $144.54 | Professional | 54 · Surgery only | $89.13 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.42 Typical High $28.84 | Professional | 55 · Aftercare only | $18.20 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.80 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $13.80 | $19.05 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $120.23 Typical High $154.88 | Professional | 51 · Multiple procedures | $69.18 | $120.23 | $154.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $43.65 Typical High $61.66 | Professional | 80 · Assistant surgeon | $27.54 | $43.65 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $30.90 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $19.50 | $30.90 | $43.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $30.90 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $30.90 | $43.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.50 Median $30.90 Typical High $43.65 | Professional | AS · PA/NP assist | $19.50 | $30.90 | $43.65 |
Where South Carolina sits
The same service costs 12.7 times more in Colorado than in North Dakota. 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 $4,551ND $359
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.