How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,288 to $20,417Professionalmedian $562 · 10th to 90th $105 to $891
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 $676.08 Median $10,232.93 Typical High $22,908.68 | Facility | None | $676.08 | $10,232.93 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $776.25 | Professional | None | $575.44 | $676.08 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $5,370.32 Typical High $19,498.45 | Facility | None | $1,621.81 | $5,370.32 | $19,498.45 |
BCBS Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,071.52 | Professional | None | $524.81 | $812.83 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,511.89 | Facility | None | $602.56 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $1,071.52 | Professional | None | $660.69 | $676.08 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $2,398.83 | Facility | None | $616.60 | $741.31 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,288.25 | Professional | None | $676.08 | $831.76 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $741.31 | Professional | None | $79.43 | $416.87 | $741.31 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,165.95 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,165.95 | $23,988.33 |
United Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $977.24 | Professional | None | $478.63 | $602.56 | $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 $288.40 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $288.40 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $114.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $426.58 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $398.11 | $467.74 | $467.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,258.93 Typical High $1,949.84 | Professional | 50 · Both sides | $1,047.13 | $1,258.93 | $1,949.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $346.74 Median $416.87 Typical High $645.65 | Professional | 51 · Multiple procedures | $346.74 | $416.87 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $169.82 Typical High $257.04 | Professional | 80 · Assistant surgeon | $138.04 | $169.82 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $97.72 Median $117.49 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $97.72 | $117.49 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $97.72 Median $117.49 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $97.72 | $117.49 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $181.97 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $181.97 |
Where South Carolina sits
The same service costs 5.1 times more in Connecticut 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
CT $9,665MT $1,888
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.