How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,995 to $4,571Professionalmedian $2,570 · 10th to 90th $1,995 to $4,571
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,995.26 Median $1,995.26 Typical High $2,818.38 | Professional | None (both parts) | $1,995.26 | $1,995.26 | $2,818.38 |
BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,073.80 | $4,570.88 | $4,570.88 |
BCBS Setting Professional Modifier None (both parts) Typical Low $2,570.40 Median $3,715.35 Typical High $4,570.88 | Professional | None (both parts) | $2,570.40 | $3,715.35 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,041.74 Typical High $2,754.23 | Professional | None (both parts) | $2,041.74 | $2,041.74 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,691.53 | Professional | None | $2,344.23 | $2,344.23 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $5,495.41 | Facility | None | $1,445.44 | $2,238.72 | $5,495.41 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,511.89 Median $3,162.28 Typical High $5,888.44 | Professional | None (both parts) | $2,511.89 | $3,162.28 | $5,888.44 |
Molina Setting Professional Modifier None (both parts) Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None (both parts) | $3,019.95 | $3,019.95 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $6,025.60 | Facility | None | $2,454.71 | $2,511.89 | $6,025.60 |
United Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $2,238.72 Typical High $3,311.31 | Professional | None (both parts) | $1,737.80 | $2,238.72 | $3,311.31 |
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 $1,000.00 Median $1,000.00 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $562.34 | Professional | 53 · Discontinued | $398.11 | $398.11 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $426.58 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $281.84 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $281.84 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $1,288.25 Median $1,348.96 Typical High $3,162.28 | Professional | 26 · Professional part | $1,288.25 | $1,348.96 | $3,162.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $4,786.30 Typical High $11,748.98 | Professional | 50 · Both sides | $3,715.35 | $4,786.30 | $11,748.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,258.93 Median $1,584.89 Typical High $3,981.07 | Professional | 51 · Multiple procedures | $1,258.93 | $1,584.89 | $3,981.07 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $630.96 Typical High $1,584.89 | Professional | 80 · Assistant surgeon | $501.19 | $630.96 | $1,584.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $446.68 Typical High $1,096.48 | Professional | 81 · Minimal assistant surgeon | $346.74 | $446.68 | $1,096.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $446.68 Typical High $1,096.48 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $446.68 | $1,096.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $446.68 Typical High $1,096.48 | Professional | AS · PA/NP assist | $346.74 | $446.68 | $1,096.48 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,905.46 Median $1,995.26 Typical High $4,677.35 | Professional | TC · Technical part | $1,905.46 | $1,995.26 | $4,677.35 |
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· 43rd of 51
$2,570
MT $5,754DE $2,042
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.