How much rates vary
Facilitymedian $1,445 · 10th to 90th $646 to $10,233Professionalmedian $437 · 10th to 90th $120 to $661
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 $363.08 Median $5,248.07 Typical High $16,595.87 | Facility | None | $363.08 | $5,248.07 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $562.34 | Professional | None | $363.08 | $457.09 | $562.34 |
BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $9,120.11 | Facility | None | $691.83 | $1,445.44 | $9,120.11 |
BCBS Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $537.03 | Professional | None | $275.42 | $354.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,348.96 Typical High $1,995.26 | Facility | None | $602.56 | $1,348.96 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $676.08 | Professional | None | $309.03 | $467.74 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $630.96 Typical High $1,412.54 | Facility | None | $363.08 | $630.96 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $602.56 | Professional | None | $407.38 | $489.78 | $602.56 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $436.52 Typical High $676.08 | Professional | None | $38.02 | $436.52 | $676.08 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $724.44 | Professional | None | $269.15 | $416.87 | $724.44 |
13 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 $177.83 Median $177.83 Typical High $281.84 | Professional | 52 · Reduced service | $177.83 | $177.83 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $114.82 | Professional | 53 · Discontinued | $72.44 | $72.44 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $426.58 | Professional | 54 · Surgery only | $269.15 | $269.15 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $85.11 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $398.11 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 50 · Both sides | $831.76 | $831.76 | $831.76 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $724.44 Typical High $1,122.02 | Professional | 50 · Both sides | $616.60 | $724.44 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $245.47 Typical High $371.54 | Professional | 51 · Multiple procedures | $204.17 | $245.47 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $147.91 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $67.61 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $57.54 | $67.61 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $67.61 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $67.61 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $67.61 Typical High $104.71 | Professional | AS · PA/NP assist | $57.54 | $67.61 | $104.71 |
Where South Carolina sits
The same service costs 5.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $6,438MT $1,226
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.