How much rates vary
Facilitymedian $955 · 10th to 90th $457 to $8,318Professionalmedian $2,138 · 10th to 90th $275 to $3,162
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 $2,630.27 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,630.27 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,187.76 | $2,630.27 | $2,630.27 |
BCBS South Carolina Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,290.87 | Professional | None | $1,862.09 | $2,137.96 | $2,290.87 |
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 $2,344.23 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,344.23 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $5,248.07 | Professional | None | $2,238.72 | $2,398.83 | $5,248.07 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,548.13 | Facility | None | $724.44 | $724.44 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,511.89 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,905.46 Typical High $3,162.28 | Professional | None | $190.55 | $1,905.46 | $3,162.28 |
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 $1,905.46 Median $2,238.72 Typical High $3,981.07 | Professional | None | $1,905.46 | $2,238.72 | $3,981.07 |
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 $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,071.52 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $436.52 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,621.81 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $218.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,819.70 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,380.38 Typical High $1,584.89 | Professional | 51 · Multiple procedures | $1,023.29 | $1,380.38 | $1,584.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $549.54 Typical High $630.96 | Professional | 80 · Assistant surgeon | $416.87 | $549.54 | $630.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $389.05 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $288.40 | $389.05 | $446.68 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $389.05 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $389.05 | $446.68 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $389.05 Typical High $446.68 | Professional | AS · PA/NP assist | $288.40 | $389.05 | $446.68 |
Where South Carolina sits
The same service costs 10.4 times more in Maine than in Maryland. 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 $29,734MD $2,853
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.