How much rates vary
Facilitymedian $1,738 · 10th to 90th $646 to $9,772Professionalmedian $490 · 10th to 90th $102 to $708
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 $407.38 Median $5,623.41 Typical High $21,877.62 | Facility | None | $407.38 | $5,623.41 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $588.84 | Professional | None | $407.38 | $489.78 | $588.84 |
BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $8,912.51 | Facility | None | $691.83 | $1,737.80 | $8,912.51 |
BCBS Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $588.84 | Professional | None | $323.59 | $524.81 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,511.89 | Facility | None | $602.56 | $1,778.28 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $812.83 | Professional | None | $426.58 | $549.54 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,479.11 | Facility | None | $407.38 | $645.65 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $691.83 | Professional | None | $588.84 | $660.69 | $691.83 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $707.95 | Professional | None | $79.43 | $416.87 | $707.95 |
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 $316.23 Median $478.63 Typical High $794.33 | Professional | None | $316.23 | $478.63 | $794.33 |
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 $204.17 Median $223.87 Typical High $295.12 | Professional | 52 · Reduced service | $204.17 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $302.00 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $67.61 Typical High $89.13 | Professional | 55 · Aftercare only | $60.26 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $316.23 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $281.84 | $316.23 | $416.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $331.13 Typical High $457.09 | Professional | 51 · Multiple procedures | $295.12 | $331.13 | $457.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $131.83 Typical High $181.97 | Professional | 80 · Assistant surgeon | $117.49 | $131.83 | $181.97 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $93.33 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $83.18 | $93.33 | $128.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $93.33 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $93.33 | $128.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $93.33 Typical High $128.82 | Professional | AS · PA/NP assist | $83.18 | $93.33 | $128.82 |
Where South Carolina sits
The same service costs 4.9 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 $6,425MT $1,300
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.