How much rates vary
Facilitymedian $891 · 10th to 90th $437 to $8,511Professionalmedian $912 · 10th to 90th $102 to $1,479
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 $812.83 Median $9,120.11 Typical High $22,908.68 | Facility | None | $812.83 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | None | $812.83 | $812.83 | $831.76 |
BCBS South Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,995.26 | Professional | None | $776.25 | $1,096.48 | $1,995.26 |
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 $870.96 Median $1,023.29 Typical High $1,819.70 | Professional | None | $870.96 | $1,023.29 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $812.83 Typical High $2,344.23 | Facility | None | $724.44 | $812.83 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,949.84 | Professional | None | $954.99 | $1,096.48 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $891.25 Typical High $1,445.44 | Professional | None | $81.28 | $891.25 | $1,445.44 |
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 $812.83 Median $977.24 Typical High $1,737.80 | Professional | None | $812.83 | $977.24 | $1,737.80 |
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 $398.11 Median $398.11 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $549.54 Typical High $977.24 | Professional | 51 · Multiple procedures | $512.86 | $549.54 | $977.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $218.78 Typical High $389.05 | Professional | 80 · Assistant surgeon | $208.93 | $218.78 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $154.88 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $144.54 | $154.88 | $275.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $154.88 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $154.88 | $275.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $154.88 Typical High $275.42 | Professional | AS · PA/NP assist | $144.54 | $154.88 | $275.42 |
Where South Carolina sits
The same service costs 18.1 times more in Maine than in Arkansas. 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 $27,451AR $1,513
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.