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 $1,380.38 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,380.38 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $109.65 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,288.25 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,862.09 | Facility | None | $1,380.38 | $1,513.56 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,348.96 | $1,479.11 | $1,548.82 |
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 $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,041.74 | Professional | None | $891.25 | $1,148.15 | $2,041.74 |
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 $741.31 Median $741.31 Typical High $831.76 | Professional | 51 · Multiple procedures | $741.31 | $741.31 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | 80 · Assistant surgeon | $302.00 | $302.00 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $208.93 | $208.93 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $208.93 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | AS · PA/NP assist | $208.93 | $208.93 | $234.42 |
Where South Carolina sits
The same service costs 5.6 times more in Alaska 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· 28th of 51
$1,380
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.