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 $165.96 Median $10,000.00 Typical High $21,877.62 | Facility | None | $165.96 | $10,000.00 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | None | $165.96 | $165.96 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,905.46 | Facility | None | $588.84 | $851.14 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $165.96 Median $181.97 Typical High $223.87 | Facility | None | $165.96 | $181.97 | $223.87 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | None | $190.55 | $190.55 | $229.09 |
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 $83.18 Median $426.58 Typical High $2,238.72 | Facility | None | $83.18 | $426.58 | $2,238.72 |
United Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $338.84 | Professional | None | $199.53 | $234.42 | $338.84 |
10 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 $83.18 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $33.11 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $123.03 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $19.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $95.50 Typical High $144.54 | Professional | 51 · Multiple procedures | $95.50 | $95.50 | $144.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $38.02 Typical High $57.54 | Professional | 80 · Assistant surgeon | $38.02 | $38.02 | $57.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.92 Median $26.92 Typical High $40.74 | Professional | 81 · Minimal assistant surgeon | $26.92 | $26.92 | $40.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.92 Median $26.92 Typical High $40.74 | Professional | 82 · Assistant surgeon, no resident | $26.92 | $26.92 | $40.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $26.92 Typical High $40.74 | Professional | AS · PA/NP assist | $26.92 | $26.92 | $40.74 |
Where South Carolina sits
The same service costs 18.6 times more in Texas than in New York. 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· 36th of 51
$219
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.