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 $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,754.23 | $2,951.21 | $2,951.21 |
BCBS Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
BCBS Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $177.83 | Professional | None | $117.49 | $147.91 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $309.03 | Facility | None | $144.54 | $177.83 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $3,235.94 Typical High $4,168.69 | Facility | None | $275.42 | $3,235.94 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $4,168.69 | Professional | None | $112.20 | $229.09 | $4,168.69 |
United Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
9 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 $1,380.38 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,380.38 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $562.34 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $416.87 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $275.42 | $295.12 | $295.12 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $114.82 Typical High $114.82 | Professional | 51 · Multiple procedures | $70.79 | $114.82 | $114.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $45.71 Typical High $45.71 | Professional | 80 · Assistant surgeon | $28.18 | $45.71 | $45.71 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $31.62 Typical High $31.62 | Professional | 81 · Minimal assistant surgeon | $19.95 | $31.62 | $31.62 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $31.62 Typical High $31.62 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $31.62 | $31.62 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.95 Median $31.62 Typical High $31.62 | Professional | AS · PA/NP assist | $19.95 | $31.62 | $31.62 |
Where South Carolina sits
The same service costs 37.2 times more in Wyoming than in North Carolina. 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· 27th of 51
$148
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.