How much rates vary
Facilitymedian $871 · 10th to 90th $331 to $8,511Professionalmedian $331 · 10th to 90th $229 to $468
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 $302.00 Median $9,120.11 Typical High $22,908.68 | Facility | None | $302.00 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | None | $263.03 | $302.00 | $302.00 |
BCBS South Carolina Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Facility | None | $6,165.95 | $6,165.95 | $6,165.95 |
BCBS South Carolina Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $524.81 | Professional | None | $229.09 | $346.74 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,905.46 | Facility | None | $100.00 | $794.33 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $588.84 | Professional | None | $275.42 | $309.03 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $245.47 Median $302.00 Typical High $724.44 | Facility | None | $245.47 | $302.00 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $457.09 | Professional | None | $295.12 | $331.13 | $457.09 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $457.09 | Professional | None | $229.09 | $331.13 | $457.09 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $537.03 | Professional | None | $251.19 | $316.23 | $537.03 |
10 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 $131.83 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $52.48 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $194.98 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.30 | $30.20 | $30.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $162.18 Typical High $234.42 | Professional | 51 · Multiple procedures | $147.91 | $162.18 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $66.07 Typical High $93.33 | Professional | 80 · Assistant surgeon | $58.88 | $66.07 | $93.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $41.69 Median $45.71 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $41.69 | $45.71 | $66.07 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $41.69 Median $45.71 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $41.69 | $45.71 | $66.07 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $45.71 Typical High $66.07 | Professional | AS · PA/NP assist | $41.69 | $45.71 | $66.07 |
Where South Carolina sits
The same service costs 32.0 times more in Maine 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
ME $26,674MT $834
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.