How much rates vary
Facilitymedian $871 · 10th to 90th $479 to $4,677Professionalmedian $309 · 10th to 90th $219 to $692
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 $309.03 Median $5,623.41 Typical High $21,877.62 | Facility | None | $309.03 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $309.03 | Professional | None | $257.04 | $309.03 | $309.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $3,981.07 | Facility | None | $512.86 | $870.96 | $3,981.07 |
BCBS South Carolina Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $363.08 | Professional | None | $218.78 | $309.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $812.83 Typical High $1,348.96 | Facility | None | $457.09 | $812.83 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $707.95 | Professional | None | $309.03 | $389.05 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $954.99 | Facility | None | $302.00 | $457.09 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $1,000.00 | Professional | None | $302.00 | $416.87 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $354.81 | Professional | None | $199.53 | $245.47 | $354.81 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,511.38 | Facility | None | $512.86 | $1,479.11 | $8,511.38 |
United Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $831.76 | Professional | None | $223.87 | $338.84 | $831.76 |
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 $128.82 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $51.29 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $190.55 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $38.02 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $25.70 | $30.90 | $30.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $275.42 Typical High $501.19 | Professional | 51 · Multiple procedures | $162.18 | $275.42 | $501.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $109.65 Typical High $199.53 | Professional | 80 · Assistant surgeon | $64.57 | $109.65 | $199.53 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $44.67 Median $75.86 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $44.67 | $75.86 | $141.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $44.67 Median $75.86 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $44.67 | $75.86 | $141.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $75.86 Typical High $141.25 | Professional | AS · PA/NP assist | $44.67 | $75.86 | $141.25 |
Where South Carolina sits
The same service costs 6.0 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 $4,737MT $787
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.