How much rates vary
Facilitymedian $3,236 · 10th to 90th $724 to $22,909Professionalmedian $1,950 · 10th to 90th $275 to $2,818
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 $2,187.76 Median $16,595.87 Typical High $37,153.52 | Facility | None | $2,187.76 | $16,595.87 | $37,153.52 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,819.70 | $2,187.76 | $2,187.76 |
BCBS South Carolina Setting Facility Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Facility | None | $21,379.62 | $21,379.62 | $21,379.62 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,137.96 | Professional | None | $1,659.59 | $1,995.26 | $2,137.96 |
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 $1,862.09 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,862.09 | $1,862.09 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $4,265.80 | Professional | None | $2,398.83 | $2,570.40 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,951.21 | Facility | None | $724.44 | $724.44 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,290.87 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,698.24 Typical High $2,818.38 | Professional | None | $190.55 | $1,698.24 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,606.93 Typical High $23,988.33 | Facility | None | $1,819.70 | $6,606.93 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,548.82 | $1,862.09 | $3,162.28 |
9 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 54 · Surgery only Typical Low $1,348.96 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,348.96 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $269.15 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $181.97 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,513.56 | $1,513.56 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,122.02 Median $1,148.15 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $1,122.02 | $1,148.15 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $467.74 Typical High $524.81 | Professional | 80 · Assistant surgeon | $446.68 | $467.74 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $323.59 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $309.03 | $323.59 | $371.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $323.59 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $323.59 | $371.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $323.59 Typical High $371.54 | Professional | AS · PA/NP assist | $309.03 | $323.59 | $371.54 |
Where South Carolina sits
The same service costs 7.2 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 $28,702DE $3,966
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.