How much rates vary
Facilitymedian $676 · 10th to 90th $85 to $2,951Professionalmedian $85 · 10th to 90th $49 to $126
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 $85.11 Median $14,125.38 Typical High $25,118.86 | Facility | None | $85.11 | $14,125.38 | $25,118.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $95.50 | Professional | None | $75.86 | $85.11 | $95.50 |
BCBS South Carolina Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $112.20 | Professional | None | $70.79 | $93.33 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $891.25 Typical High $1,995.26 | Facility | None | $602.56 | $891.25 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $2,041.74 | Facility | None | $77.62 | $95.50 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $162.18 | Professional | None | $77.62 | $91.20 | $162.18 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $60.26 | Professional | None | $33.11 | $41.69 | $60.26 |
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 $70.79 Median $91.20 Typical High $151.36 | Professional | None | $70.79 | $91.20 | $151.36 |
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 $40.74 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $40.74 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.22 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 54 · Surgery only | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.30 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.13 | $8.51 | $8.51 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $138.04 Typical High $239.88 | Professional | 50 · Both sides | $117.49 | $138.04 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $45.71 Typical High $81.28 | Professional | 51 · Multiple procedures | $38.90 | $45.71 | $81.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $15.49 Median $18.20 Typical High $32.36 | Professional | 80 · Assistant surgeon | $15.49 | $18.20 | $32.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.96 Median $12.88 Typical High $22.39 | Professional | 81 · Minimal assistant surgeon | $10.96 | $12.88 | $22.39 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.96 Median $12.88 Typical High $22.39 | Professional | 82 · Assistant surgeon, no resident | $10.96 | $12.88 | $22.39 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $12.88 Typical High $22.39 | Professional | AS · PA/NP assist | $10.96 | $12.88 | $22.39 |
Where South Carolina sits
The same service costs 16.6 times more in Alabama 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
AL $3,321DE $200
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.