How much rates vary
Facilitymedian $1,905 · 10th to 90th $224 to $10,000Professionalmedian $380 · 10th to 90th $229 to $912
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 $363.08 Median $10,964.78 Typical High $21,877.62 | Facility | None | $363.08 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | None | $363.08 | $363.08 | $371.54 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $10,232.93 | Facility | None | $1,000.00 | $1,905.46 | $10,232.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $229.09 Median $616.60 Typical High $912.01 | Professional | None | $229.09 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $891.25 Typical High $1,905.46 | Facility | None | $602.56 | $891.25 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $524.81 | Professional | None | $288.40 | $338.84 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $812.83 Typical High $1,202.26 | Facility | None | $363.08 | $812.83 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $933.25 | Professional | None | $275.42 | $331.13 | $933.25 |
Molina Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $446.68 | Professional | None | $234.42 | $354.81 | $446.68 |
United Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $602.56 | Professional | None | $295.12 | $371.54 | $602.56 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $208.93 Typical High $467.74 | Professional | 51 · Multiple procedures | $138.04 | $208.93 | $467.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $83.18 Typical High $162.18 | Professional | 80 · Assistant surgeon | $54.95 | $83.18 | $162.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.90 Median $57.54 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $38.90 | $57.54 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.90 Median $57.54 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $38.90 | $57.54 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $57.54 Typical High $114.82 | Professional | AS · PA/NP assist | $38.90 | $57.54 | $114.82 |
Where South Carolina sits
The same service costs 10.0 times more in New York than in Delaware. 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
NY $4,696DE $472
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.