How much rates vary
Facilitymedian $1,549 · 10th to 90th $603 to $14,125Professionalmedian $2,138 · 10th to 90th $275 to $3,090
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 $2,570.40 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,570.40 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,137.96 | $2,570.40 | $2,570.40 |
BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,819.70 | $2,344.23 |
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 $2,187.76 Median $2,238.72 Typical High $3,467.37 | Professional | None | $2,187.76 | $2,238.72 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $5,128.61 | Professional | None | $2,089.30 | $2,238.72 | $5,128.61 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,467.37 | Facility | None | $724.44 | $724.44 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,454.71 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,862.09 Typical High $3,090.30 | Professional | None | $190.55 | $1,862.09 | $3,090.30 |
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 $1,819.70 Median $2,187.76 Typical High $3,801.89 | Professional | None | $1,819.70 | $2,187.76 | $3,801.89 |
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 $1,071.52 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,071.52 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $426.58 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,584.89 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $213.80 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,778.28 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $1,318.26 Typical High $1,548.82 | Professional | 51 · Multiple procedures | $954.99 | $1,318.26 | $1,548.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $524.81 Typical High $616.60 | Professional | 80 · Assistant surgeon | $389.05 | $524.81 | $616.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $371.54 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $275.42 | $371.54 | $436.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $371.54 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $371.54 | $436.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $371.54 Typical High $436.52 | Professional | AS · PA/NP assist | $275.42 | $371.54 | $436.52 |
Where South Carolina sits
The same service costs 9.3 times more in Maine than in Delaware. 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 $29,670DE $3,198
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.