How much rates vary
Facilitymedian $955 · 10th to 90th $457 to $9,333Professionalmedian $851 · 10th to 90th $107 to $1,259
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 $1,000.00 Median $11,481.54 Typical High $21,877.62 | Facility | None | $1,000.00 | $11,481.54 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | None | $851.14 | $1,000.00 | $1,000.00 |
BCBS Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $912.01 | Professional | None | $758.58 | $851.14 | $912.01 |
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 $851.14 Median $851.14 Typical High $1,380.38 | Professional | None | $851.14 | $851.14 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,071.52 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $724.44 Typical High $1,348.96 | Facility | None | $660.69 | $724.44 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,202.26 | Professional | None | $933.25 | $977.24 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $776.25 Typical High $1,288.25 | Professional | None | $75.86 | $776.25 | $1,288.25 |
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 $724.44 Median $870.96 Typical High $1,445.44 | Professional | None | $724.44 | $870.96 | $1,445.44 |
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 $416.87 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $707.95 | $707.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $512.86 Typical High $602.56 | Professional | 51 · Multiple procedures | $467.74 | $512.86 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $208.93 Typical High $245.47 | Professional | 80 · Assistant surgeon | $186.21 | $208.93 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $144.54 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $128.82 | $144.54 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $144.54 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $144.54 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $144.54 Typical High $169.82 | Professional | AS · PA/NP assist | $128.82 | $144.54 | $169.82 |
Where South Carolina sits
The same service costs 11.8 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 $16,971MD $1,433
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.