How much rates vary
Facilitymedian $7,943 · 10th to 90th $2,692 to $33,113Professionalmedian $1,585 · 10th to 90th $251 to $2,399
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 $1,905.46 Median $11,481.54 Typical High $21,877.62 | Facility | None | $1,905.46 | $11,481.54 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,905.46 | $1,905.46 |
BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $6,918.31 Typical High $36,307.81 | Facility | None | $3,467.37 | $6,918.31 | $36,307.81 |
BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,884.03 | Professional | None | $1,513.56 | $2,041.74 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $14,454.40 Typical High $20,417.38 | Facility | None | $602.56 | $14,454.40 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,862.09 | $1,862.09 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $29,512.09 | Facility | None | $1,412.54 | $1,905.46 | $29,512.09 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,238.72 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,230.27 Typical High $2,137.96 | Professional | None | $199.53 | $1,230.27 | $2,137.96 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $13,182.57 Typical High $33,884.42 | Facility | None | $3,311.31 | $13,182.57 | $33,884.42 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,737.80 | $2,754.23 |
11 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 $812.83 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $812.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $331.13 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,230.27 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $245.47 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $162.18 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,318.26 | $1,318.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,174.90 Typical High $1,479.11 | Professional | 51 · Multiple procedures | $1,000.00 | $1,174.90 | $1,479.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $478.63 Typical High $588.84 | Professional | 80 · Assistant surgeon | $398.11 | $478.63 | $588.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $331.13 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $275.42 | $331.13 | $416.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $331.13 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $331.13 | $416.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $331.13 Typical High $416.87 | Professional | AS · PA/NP assist | $275.42 | $331.13 | $416.87 |
Where South Carolina sits
The same service costs 6.4 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.
Physician feeFacility fee
WY $22,945KY $3,609
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.