How much rates vary
Facilitymedian $490 · 10th to 90th $468 to $955Professionalmedian $550 · 10th to 90th $398 to $955
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 $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None (both parts) Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | None (both parts) | $467.74 | $467.74 | $562.34 |
BCBS Setting Facility Modifier None Typical Low $870.96 Median $954.99 Typical High $954.99 | Facility | None | $870.96 | $954.99 | $954.99 |
BCBS Setting Professional Modifier None (both parts) Typical Low $549.54 Median $794.33 Typical High $954.99 | Professional | None (both parts) | $549.54 | $794.33 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $363.08 Median $363.08 Typical High $575.44 | Professional | None (both parts) | $363.08 | $363.08 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | None | $398.11 | $398.11 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $257.04 Median $524.81 Typical High $1,174.90 | Facility | None | $257.04 | $524.81 | $1,174.90 |
Medcost Setting Professional Modifier None (both parts) Typical Low $537.03 Median $676.08 Typical High $1,258.93 | Professional | None (both parts) | $537.03 | $676.08 | $1,258.93 |
Molina Setting Professional Modifier None (both parts) Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None (both parts) | $645.65 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $1,071.52 | Facility | None | $478.63 | $524.81 | $1,071.52 |
United Setting Professional Modifier None (both parts) Typical Low $316.23 Median $457.09 Typical High $575.44 | Professional | None (both parts) | $316.23 | $457.09 | $575.44 |
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 $234.42 Median $234.42 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $114.82 | Professional | 53 · Discontinued | $93.33 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $56.23 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $281.84 Typical High $676.08 | Professional | 26 · Professional part | $269.15 | $281.84 | $676.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,023.29 Typical High $2,511.89 | Professional | 50 · Both sides | $794.33 | $1,023.29 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $338.84 Typical High $831.76 | Professional | 51 · Multiple procedures | $263.03 | $338.84 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $134.90 Typical High $338.84 | Professional | 80 · Assistant surgeon | $107.15 | $134.90 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $95.50 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $74.13 | $95.50 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $95.50 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $95.50 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $95.50 Typical High $234.42 | Professional | AS · PA/NP assist | $74.13 | $95.50 | $234.42 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $407.38 Median $426.58 Typical High $1,000.00 | Professional | TC · Technical part | $407.38 | $426.58 | $1,000.00 |
Where South Carolina sits
The same service costs 3.2 times more in Hawaii 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.
South Carolina· 23rd of 51
$550
HI $1,175DE $363
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.