How much rates vary
Facilitymedian $1,175 · 10th to 90th $501 to $6,607Professionalmedian $145 · 10th to 90th $95 to $229
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 $5,623.41 Typical High $21,877.62 | Facility | None | $125.89 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $177.83 | Professional | None | $125.89 | $138.04 | $177.83 |
BCBS South Carolina Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $6,760.83 | Facility | None | $691.83 | $1,288.25 | $6,760.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $169.82 | Professional | None | $83.18 | $134.90 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $1,862.09 | Facility | None | $602.56 | $1,202.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $234.42 | Professional | None | $85.11 | $128.82 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $588.84 Typical High $851.14 | Facility | None | $114.82 | $588.84 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $323.59 | Professional | None | $120.23 | $162.18 | $323.59 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $251.19 | Professional | None | $125.89 | $194.98 | $251.19 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $6,606.93 | Facility | None | $302.00 | $1,122.02 | $6,606.93 |
United Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $229.09 | Professional | None | $95.50 | $138.04 | $229.09 |
11 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 $63.10 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $63.10 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $25.12 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $100.00 Typical High $131.83 | Professional | 54 · Surgery only | $95.50 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $17.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $263.03 Typical High $478.63 | Professional | 50 · Both sides | $181.97 | $263.03 | $478.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $87.10 Typical High $162.18 | Professional | 51 · Multiple procedures | $60.26 | $87.10 | $162.18 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.99 Median $34.67 Typical High $63.10 | Professional | 80 · Assistant surgeon | $23.99 | $34.67 | $63.10 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.98 Median $24.55 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $16.98 | $24.55 | $43.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $24.55 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $24.55 | $43.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $24.55 Typical High $43.65 | Professional | AS · PA/NP assist | $16.98 | $24.55 | $43.65 |
Where South Carolina sits
The same service costs 10.9 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 $3,950MT $363
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.