How much rates vary
Facilitymedian $1,778 · 10th to 90th $661 to $8,913Professionalmedian $589 · 10th to 90th $120 to $813
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 $588.84 Median $9,120.11 Typical High $21,877.62 | Facility | None | $588.84 | $9,120.11 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $676.08 | Professional | None | $575.44 | $588.84 | $676.08 |
BCBS Setting Facility Modifier None Typical Low $851.14 Median $2,187.76 Typical High $9,332.54 | Facility | None | $851.14 | $2,187.76 | $9,332.54 |
BCBS Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $707.95 | Professional | None | $457.09 | $602.56 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $2,041.74 | Facility | None | $602.56 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $831.76 | Professional | None | $436.52 | $575.44 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,513.56 | Facility | None | $457.09 | $741.31 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $977.24 | Professional | None | $549.54 | $707.95 | $977.24 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $478.63 Typical High $812.83 | Professional | None | $79.43 | $478.63 | $812.83 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $8,912.51 | Facility | None | $512.86 | $1,479.11 | $8,912.51 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $977.24 | Professional | None | $436.52 | $562.34 | $977.24 |
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 $295.12 Median $295.12 Typical High $331.13 | Professional | 52 · Reduced service | $295.12 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $467.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,202.26 Typical High $1,479.11 | Professional | 50 · Both sides | $831.76 | $1,202.26 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $398.11 Typical High $489.78 | Professional | 51 · Multiple procedures | $275.42 | $398.11 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $158.49 Typical High $194.98 | Professional | 80 · Assistant surgeon | $112.20 | $158.49 | $194.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $77.62 Median $112.20 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $77.62 | $112.20 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $77.62 Median $112.20 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $77.62 | $112.20 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $112.20 Typical High $138.04 | Professional | AS · PA/NP assist | $77.62 | $112.20 | $138.04 |
Where South Carolina sits
The same service costs 3.7 times more in Colorado than in Delaware. 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 $5,124DE $1,369
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.