How much rates vary
Facilitymedian $302 · 10th to 90th $120 to $457Professionalmedian $35 · 10th to 90th $17 to $45
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 $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None (both parts) Typical Low $17.78 Median $18.20 Typical High $18.20 | Professional | None (both parts) | $17.78 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $13.80 Median $14.79 Typical High $14.79 | Professional | 26 · Professional part | $13.80 | $14.79 | $14.79 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $3.47 Median $3.55 Typical High $3.55 | Professional | TC · Technical part | $3.47 | $3.55 | $3.55 |
BCBS Setting Facility Modifier None Typical Low $138.04 Median $316.23 Typical High $446.68 | Facility | None | $138.04 | $316.23 | $446.68 |
BCBS Setting Facility Modifier TC · Technical part Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | TC · Technical part | $190.55 | $190.55 | $190.55 |
BCBS Setting Professional Modifier None (both parts) Typical Low $16.98 Median $34.67 Typical High $44.67 | Professional | None (both parts) | $16.98 | $34.67 | $44.67 |
BCBS Setting Professional Modifier 26 · Professional part Typical Low $13.49 Median $16.98 Typical High $25.12 | Professional | 26 · Professional part | $13.49 | $16.98 | $25.12 |
BCBS Setting Professional Modifier TC · Technical part Typical Low $3.39 Median $8.91 Typical High $27.54 | Professional | TC · Technical part | $3.39 | $8.91 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.05 Median $35.48 Typical High $46.77 | Professional | None (both parts) | $19.05 | $35.48 | $46.77 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $10.96 Median $10.96 Typical High $15.49 | Professional | 26 · Professional part | $10.96 | $10.96 | $15.49 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $3.47 Median $24.55 Typical High $33.11 | Professional | TC · Technical part | $3.47 | $24.55 | $33.11 |
Medcost Setting Facility Modifier None Typical Low $18.20 Median $24.55 Typical High $48.98 | Facility | None | $18.20 | $24.55 | $48.98 |
Medcost Setting Professional Modifier None (both parts) Typical Low $20.42 Median $41.69 Typical High $50.12 | Professional | None (both parts) | $20.42 | $41.69 | $50.12 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $13.80 Median $16.98 Typical High $23.99 | Professional | 26 · Professional part | $13.80 | $16.98 | $23.99 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $5.89 Median $28.84 Typical High $33.88 | Professional | TC · Technical part | $5.89 | $28.84 | $33.88 |
United Setting Facility Modifier None Typical Low $537.03 Median $660.69 Typical High $851.14 | Facility | None | $537.03 | $660.69 | $851.14 |
United Setting Professional Modifier None (both parts) Typical Low $13.49 Median $16.98 Typical High $44.67 | Professional | None (both parts) | $13.49 | $16.98 | $44.67 |
United Setting Professional Modifier 26 · Professional part Typical Low $11.22 Median $12.88 Typical High $15.49 | Professional | 26 · Professional part | $11.22 | $12.88 | $15.49 |
United Setting Professional Modifier TC · Technical part Typical Low $2.29 Median $3.09 Typical High $30.90 | Professional | TC · Technical part | $2.29 | $3.09 | $30.90 |
7 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 $8.71 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $8.71 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.55 | $3.63 | $3.63 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $12.88 Median $20.89 Typical High $25.12 | Professional | 51 · Multiple procedures | $12.88 | $20.89 | $25.12 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $5.13 Median $8.32 Typical High $10.00 | Professional | 80 · Assistant surgeon | $5.13 | $8.32 | $10.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $3.55 Median $5.89 Typical High $7.08 | Professional | 81 · Minimal assistant surgeon | $3.55 | $5.89 | $7.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $3.55 Median $5.89 Typical High $7.08 | Professional | 82 · Assistant surgeon, no resident | $3.55 | $5.89 | $7.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $3.55 Median $5.89 Typical High $7.08 | Professional | AS · PA/NP assist | $3.55 | $5.89 | $7.08 |
Where South Carolina sits
The same service costs 2.5 times more in California than in New York. 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· 3rd of 51
$34.67
CA $40.74NY $16.22
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.