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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $19.05 Typical High $19.05 | Professional | None | $12.88 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.46 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $6.46 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $1.91 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.29 | $1.95 | $1.95 |
Medcost Setting Facility Modifier None Typical Low $19.05 Median $21.38 Typical High $25.70 | Facility | None | $19.05 | $21.38 | $25.70 |
Medcost Setting Professional Modifier None Typical Low $13.49 Median $14.79 Typical High $23.44 | Professional | None | $13.49 | $14.79 | $23.44 |
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 Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $61.66 | Professional | None | $28.84 | $36.31 | $61.66 |
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 $6.76 Median $9.33 Typical High $11.75 | Professional | 51 · Multiple procedures | $6.76 | $9.33 | $11.75 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $2.75 Median $3.72 Typical High $4.68 | Professional | 80 · Assistant surgeon | $2.75 | $3.72 | $4.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1.91 Median $2.57 Typical High $3.31 | Professional | 81 · Minimal assistant surgeon | $1.91 | $2.57 | $3.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1.91 Median $2.57 Typical High $3.31 | Professional | 82 · Assistant surgeon, no resident | $1.91 | $2.57 | $3.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $1.91 Median $2.57 Typical High $3.31 | Professional | AS · PA/NP assist | $1.91 | $2.57 | $3.31 |
Where South Carolina sits
The same service costs 14.5 times more in Texas than in West Virginia. 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· 31st of 51
$19.05
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.