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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None (both parts) Typical Low $35.48 Median $35.48 Typical High $52.48 | Professional | None (both parts) | $35.48 | $35.48 | $52.48 |
Cigna Setting Professional Modifier None (both parts) Typical Low $42.66 Median $52.48 Typical High $85.11 | Professional | None (both parts) | $42.66 | $52.48 | $85.11 |
Medcost Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $97.72 | Professional | None | $63.10 | $63.10 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $35.48 Median $58.88 Typical High $104.71 | Facility | None | $35.48 | $58.88 | $104.71 |
Medcost Setting Professional Modifier None (both parts) Typical Low $44.67 Median $56.23 Typical High $70.79 | Professional | None (both parts) | $44.67 | $56.23 | $70.79 |
Molina Setting Professional Modifier None (both parts) Typical Low $34.67 Median $44.67 Typical High $66.07 | Professional | None (both parts) | $34.67 | $44.67 | $66.07 |
United Setting Professional Modifier None (both parts) Typical Low $42.66 Median $52.48 Typical High $81.28 | Professional | None (both parts) | $42.66 | $52.48 | $81.28 |
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 $16.98 Median $17.78 Typical High $26.30 | Professional | 52 · Reduced service | $16.98 | $17.78 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $7.76 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.55 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.39 | $3.55 | $5.25 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $51.29 Median $51.29 Typical High $63.10 | Professional | 29 | $51.29 | $51.29 | $63.10 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $26.30 Typical High $32.36 | Professional | 26 · Professional part | $17.78 | $26.30 | $32.36 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $93.33 Typical High $125.89 | Professional | 50 · Both sides | $67.61 | $93.33 | $125.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $22.39 Median $30.90 Typical High $42.66 | Professional | 51 · Multiple procedures | $22.39 | $30.90 | $42.66 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $8.91 Median $12.30 Typical High $16.98 | Professional | 80 · Assistant surgeon | $8.91 | $12.30 | $16.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $6.31 Median $8.71 Typical High $11.75 | Professional | 81 · Minimal assistant surgeon | $6.31 | $8.71 | $11.75 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $6.31 Median $8.71 Typical High $11.75 | Professional | 82 · Assistant surgeon, no resident | $6.31 | $8.71 | $11.75 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $6.31 Median $8.71 Typical High $11.75 | Professional | AS · PA/NP assist | $6.31 | $8.71 | $11.75 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $26.92 Median $39.81 Typical High $47.86 | Professional | TC · Technical part | $26.92 | $39.81 | $47.86 |
Where South Carolina sits
The same service costs 2.6 times more in Nebraska than in Texas. 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· 32nd of 51
$51.29
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.