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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $79.43 | Professional | None | $70.79 | $74.13 | $79.43 |
BCBS Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $251.19 | Professional | None | $117.49 | $147.91 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $309.03 | Facility | None | $144.54 | $223.87 | $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 $74.13 Median $89.13 Typical High $302.00 | Facility | None | $74.13 | $89.13 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $302.00 | Professional | None | $177.83 | $177.83 | $302.00 |
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 $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 $35.48 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $35.48 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $14.13 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $11.48 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.08 | $7.41 | $7.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $89.13 Typical High $165.96 | Professional | 51 · Multiple procedures | $89.13 | $89.13 | $165.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $35.48 Typical High $66.07 | Professional | 80 · Assistant surgeon | $35.48 | $35.48 | $66.07 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.12 Median $25.12 Typical High $46.77 | Professional | 81 · Minimal assistant surgeon | $25.12 | $25.12 | $46.77 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.12 Median $25.12 Typical High $46.77 | Professional | 82 · Assistant surgeon, no resident | $25.12 | $25.12 | $46.77 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $25.12 Median $25.12 Typical High $46.77 | Professional | AS · PA/NP assist | $25.12 | $25.12 | $46.77 |
Where South Carolina sits
The same service costs 3.6 times more in Wyoming than in Kentucky. 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· 18th of 51
$126
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.