How much rates vary
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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $85.11 | Professional | None | $79.43 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $40.74 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.30 Typical High $12.88 | Professional | 55 · Aftercare only | $12.02 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Medcost Setting Facility Modifier None Typical Low $77.62 Median $85.11 Typical High $109.65 | Facility | None | $77.62 | $85.11 | $109.65 |
Medcost Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $151.36 | Professional | None | $87.10 | $87.10 | $151.36 |
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 $1,445.44 Median $1,737.80 Typical High $2,290.87 | Facility | None | $1,445.44 | $1,737.80 | $2,290.87 |
United Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $173.78 | Professional | None | $77.62 | $100.00 | $173.78 |
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 $43.65 Median $43.65 Typical High $138.04 | Professional | 51 · Multiple procedures | $43.65 | $43.65 | $138.04 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.38 Median $17.38 Typical High $54.95 | Professional | 80 · Assistant surgeon | $17.38 | $17.38 | $54.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.30 Median $12.30 Typical High $38.90 | Professional | 81 · Minimal assistant surgeon | $12.30 | $12.30 | $38.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.30 Median $12.30 Typical High $38.90 | Professional | 82 · Assistant surgeon, no resident | $12.30 | $12.30 | $38.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $12.30 Median $12.30 Typical High $38.90 | Professional | AS · PA/NP assist | $12.30 | $12.30 | $38.90 |
Where South Carolina sits
The same service costs 5.0 times more in Alaska than in Pennsylvania. 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· 46th of 51
$85.11
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.