How much rates vary
Facilitymedian $166 · 10th to 90th $132 to $302Professionalmedian $174 · 10th to 90th $132 to $302
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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $131.83 Median $131.83 Typical High $186.21 | Professional | None (both parts) | $131.83 | $131.83 | $186.21 |
BCBS Setting Facility Modifier None Typical Low $269.15 Median $302.00 Typical High $302.00 | Facility | None | $269.15 | $302.00 | $302.00 |
BCBS Setting Professional Modifier None (both parts) Typical Low $173.78 Median $251.19 Typical High $302.00 | Professional | None (both parts) | $173.78 | $251.19 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None (both parts) Typical Low $120.23 Median $120.23 Typical High $177.83 | Professional | None (both parts) | $120.23 | $120.23 | $177.83 |
Medcost Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | None | $134.90 | $134.90 | $158.49 |
Medcost Setting Facility Modifier None Typical Low $85.11 Median $144.54 Typical High $363.08 | Facility | None | $85.11 | $144.54 | $363.08 |
Medcost Setting Professional Modifier None (both parts) Typical Low $165.96 Median $208.93 Typical High $389.05 | Professional | None (both parts) | $165.96 | $208.93 | $389.05 |
Molina Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None (both parts) | $199.53 | $199.53 | $199.53 |
United Setting Facility Modifier None Typical Low $134.90 Median $141.25 Typical High $363.08 | Facility | None | $134.90 | $141.25 | $363.08 |
United Setting Professional Modifier None (both parts) Typical Low $109.65 Median $147.91 Typical High $199.53 | Professional | None (both parts) | $109.65 | $147.91 | $199.53 |
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 $66.07 Median $66.07 Typical High $93.33 | Professional | 52 · Reduced service | $66.07 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $37.15 | Professional | 53 · Discontinued | $26.30 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $28.18 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $18.62 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $85.11 Median $89.13 Typical High $208.93 | Professional | 26 · Professional part | $85.11 | $89.13 | $208.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $316.23 Typical High $776.25 | Professional | 50 · Both sides | $245.47 | $316.23 | $776.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $104.71 Typical High $263.03 | Professional | 51 · Multiple procedures | $83.18 | $104.71 | $263.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.11 Median $42.66 Typical High $104.71 | Professional | 80 · Assistant surgeon | $33.11 | $42.66 | $104.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $22.91 Median $29.51 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $22.91 | $29.51 | $72.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $22.91 Median $29.51 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $22.91 | $29.51 | $72.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $22.91 Median $29.51 Typical High $72.44 | Professional | AS · PA/NP assist | $22.91 | $29.51 | $72.44 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $131.83 Typical High $316.23 | Professional | TC · Technical part | $125.89 | $131.83 | $316.23 |
Where South Carolina sits
The same service costs 2.8 times more in Montana 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· 33rd of 51
$174
MT $331DE $120
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.