How much rates vary
Facilitymedian $692 · 10th to 90th $324 to $2,042Professionalmedian $63 · 10th to 90th $48 to $112
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 $346.74 Median $1,258.93 Typical High $2,398.83 | Facility | None | $346.74 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $77.62 | Professional | None | $45.71 | $58.88 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $95.50 Typical High $123.03 | Professional | None | $53.70 | $95.50 | $123.03 |
BCBS South Carolina Setting Facility Modifier None Typical Low $302.00 Median $524.81 Typical High $912.01 | Facility | None | $302.00 | $524.81 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $3,235.94 | Facility | None | $1,122.02 | $1,548.82 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $97.72 | Professional | None | $56.23 | $60.26 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $141.25 | Professional | None | $66.07 | $87.10 | $141.25 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $131.83 | Professional | None | $66.07 | $85.11 | $131.83 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $4,897.79 | Facility | None | $1,288.25 | $2,137.96 | $4,897.79 |
United Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $107.15 | Professional | None | $53.70 | $63.10 | $107.15 |
14 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 $29.51 Median $30.20 Typical High $32.36 | Professional | 52 · Reduced service | $29.51 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.12 Typical High $9.55 | Professional | 55 · Aftercare only | $8.91 | $9.12 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.03 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.89 | $6.03 | $6.46 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 24 · Unrelated visit after surgery | $95.50 | $95.50 | $95.50 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $72.44 Median $85.11 Typical High $123.03 | Professional | 25 · Same-day visit | $72.44 | $85.11 | $123.03 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $72.44 Median $74.13 Typical High $125.89 | Professional | 57 · Decision for surgery | $72.44 | $74.13 | $125.89 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | FS · Shared visit | $95.50 | $95.50 | $95.50 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $100.00 Median $100.00 Typical High $125.89 | Professional | GC · Resident with teaching physician | $100.00 | $100.00 | $125.89 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $67.61 Median $81.28 Typical High $102.33 | Professional | 29 | $67.61 | $81.28 | $102.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $44.67 Typical High $70.79 | Professional | 51 · Multiple procedures | $33.11 | $44.67 | $70.79 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.18 Median $18.20 Typical High $28.18 | Professional | 80 · Assistant surgeon | $13.18 | $18.20 | $28.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $12.59 Typical High $19.95 | Professional | 81 · Minimal assistant surgeon | $9.33 | $12.59 | $19.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $12.59 Typical High $19.95 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $12.59 | $19.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $9.33 Median $12.59 Typical High $19.95 | Professional | AS · PA/NP assist | $9.33 | $12.59 | $19.95 |
Where South Carolina sits
The same service costs 11.2 times more in California than in Idaho. 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
CA $2,527ID $226
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.