How much rates vary
Facilitymedian $214 · 10th to 90th $126 to $288Professionalmedian $166 · 10th to 90th $120 to $288
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | None (both parts) | $125.89 | $125.89 | $165.96 |
BCBS Setting Facility Modifier None Typical Low $257.04 Median $288.40 Typical High $288.40 | Facility | None | $257.04 | $288.40 | $288.40 |
BCBS Setting Professional Modifier None (both parts) Typical Low $120.23 Median $173.78 Typical High $288.40 | Professional | None (both parts) | $120.23 | $173.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | None (both parts) | $154.88 | $154.88 | $213.80 |
Medcost Setting Facility Modifier None Typical Low $69.18 Median $138.04 Typical High $338.84 | Facility | None | $69.18 | $138.04 | $338.84 |
Medcost Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | None (both parts) | $269.15 | $269.15 | $338.84 |
Molina Setting Professional Modifier None (both parts) Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None (both parts) | $234.42 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None (both parts) Typical Low $114.82 Median $169.82 Typical High $234.42 | Professional | None (both parts) | $114.82 | $169.82 | $234.42 |
12 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 $63.10 Typical High $83.18 | Professional | 52 · Reduced service | $63.10 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $33.11 | Professional | 53 · Discontinued | $25.12 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $25.12 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $16.60 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $109.65 Median $109.65 Typical High $177.83 | Professional | 26 · Professional part | $109.65 | $109.65 | $177.83 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $407.38 Typical High $676.08 | Professional | 50 · Both sides | $407.38 | $407.38 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | 51 · Multiple procedures | $134.90 | $134.90 | $223.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $54.95 Typical High $89.13 | Professional | 80 · Assistant surgeon | $54.95 | $54.95 | $89.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $38.02 Median $38.02 Typical High $63.10 | Professional | 81 · Minimal assistant surgeon | $38.02 | $38.02 | $63.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $38.02 Median $38.02 Typical High $63.10 | Professional | 82 · Assistant surgeon, no resident | $38.02 | $38.02 | $63.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $38.02 Typical High $63.10 | Professional | AS · PA/NP assist | $38.02 | $38.02 | $63.10 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $162.18 Median $162.18 Typical High $269.15 | Professional | TC · Technical part | $162.18 | $162.18 | $269.15 |
Where South Carolina sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 41st of 51
$166
HI $347UT $132
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.