How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $16.98 | Professional | None | $15.14 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $7.41 Typical High $8.51 | Professional | 52 · Reduced service | $7.41 | $7.41 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.39 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.51 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $1.70 |
BCBS South Carolina Setting Facility Modifier None Typical Low $95.50 Median $162.18 Typical High $281.84 | Facility | None | $95.50 | $162.18 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Medcost Setting Facility Modifier None Typical Low $15.14 Median $17.78 Typical High $20.42 | Facility | None | $15.14 | $17.78 | $20.42 |
Medcost Setting Professional Modifier None Typical Low $10.47 Median $15.14 Typical High $21.38 | Professional | None | $10.47 | $15.14 | $21.38 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $446.68 Median $1,202.26 Typical High $2,951.21 | Facility | None | $446.68 | $1,202.26 | $2,951.21 |
United Setting Professional Modifier None Typical Low $14.45 Median $18.62 Typical High $28.18 | Professional | None | $14.45 | $18.62 | $28.18 |
5 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 |
|---|---|---|---|---|---|
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.25 Median $7.59 Typical High $14.13 | Professional | 51 · Multiple procedures | $5.25 | $7.59 | $14.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.14 Median $3.02 Typical High $5.62 | Professional | 80 · Assistant surgeon | $2.14 | $3.02 | $5.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.48 Median $2.14 Typical High $3.98 | Professional | 81 · Minimal assistant surgeon | $1.48 | $2.14 | $3.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.48 Median $2.14 Typical High $3.98 | Professional | 82 · Assistant surgeon, no resident | $1.48 | $2.14 | $3.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.48 Median $2.14 Typical High $3.98 | Professional | AS · PA/NP assist | $1.48 | $2.14 | $3.98 |
Where South Carolina sits
The same service costs 19.1 times more in Indiana 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· 44th of 51
$16.98
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.