How much rates vary
Facilitymedian $126 · 10th to 90th $87 to $195Professionalmedian $115 · 10th to 90th $87 to $195
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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $87.10 Median $87.10 Typical High $123.03 | Professional | None (both parts) | $87.10 | $87.10 | $123.03 |
BCBS Setting Facility Modifier None Typical Low $177.83 Median $194.98 Typical High $194.98 | Facility | None | $177.83 | $194.98 | $194.98 |
BCBS Setting Professional Modifier None (both parts) Typical Low $114.82 Median $165.96 Typical High $194.98 | Professional | None (both parts) | $114.82 | $165.96 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None (both parts) | $93.33 | $93.33 | $125.89 |
Medcost Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | None | $117.49 | $117.49 | $134.90 |
Medcost Setting Facility Modifier None Typical Low $61.66 Median $102.33 Typical High $239.88 | Facility | None | $61.66 | $102.33 | $239.88 |
Medcost Setting Professional Modifier None (both parts) Typical Low $107.15 Median $138.04 Typical High $257.04 | Professional | None (both parts) | $107.15 | $138.04 | $257.04 |
Molina Setting Professional Modifier None (both parts) Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None (both parts) | $128.82 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $263.03 | Facility | None | $100.00 | $120.23 | $263.03 |
United Setting Professional Modifier None (both parts) Typical Low $75.86 Median $95.50 Typical High $144.54 | Professional | None (both parts) | $75.86 | $95.50 | $144.54 |
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 $42.66 Median $42.66 Typical High $61.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $24.55 | Professional | 53 · Discontinued | $17.38 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $18.20 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $12.30 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $57.54 Typical High $134.90 | Professional | 26 · Professional part | $54.95 | $57.54 | $134.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $208.93 Typical High $512.86 | Professional | 50 · Both sides | $162.18 | $208.93 | $512.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $53.70 Median $69.18 Typical High $169.82 | Professional | 51 · Multiple procedures | $53.70 | $69.18 | $169.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.38 Median $27.54 Typical High $67.61 | Professional | 80 · Assistant surgeon | $21.38 | $27.54 | $67.61 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $15.14 Median $19.50 Typical High $47.86 | Professional | 81 · Minimal assistant surgeon | $15.14 | $19.50 | $47.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $15.14 Median $19.50 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $15.14 | $19.50 | $47.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $19.50 Typical High $47.86 | Professional | AS · PA/NP assist | $15.14 | $19.50 | $47.86 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $83.18 Median $87.10 Typical High $204.17 | Professional | TC · Technical part | $83.18 | $87.10 | $204.17 |
Where South Carolina sits
The same service costs 2.9 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· 42nd of 51
$115
HI $269DE $93.33
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.