How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $1,738 · 10th to 90th $275 to $2,630
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 $2,089.30 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,089.30 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,737.80 | $2,089.30 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,584.89 | $2,041.74 |
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 $1,659.59 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,659.59 | $1,737.80 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $4,073.80 | Professional | None | $1,737.80 | $1,862.09 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,818.38 | Facility | None | $724.44 | $724.44 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,995.26 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,621.81 Typical High $2,691.53 | Professional | None | $190.55 | $1,621.81 | $2,691.53 |
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 $1,479.11 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,778.28 | $2,951.21 |
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 $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $870.96 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $346.74 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,288.25 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $257.04 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,445.44 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $1,047.13 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $812.83 | $1,047.13 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $426.58 Typical High $501.19 | Professional | 80 · Assistant surgeon | $331.13 | $426.58 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $295.12 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $229.09 | $295.12 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $295.12 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $295.12 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $295.12 Typical High $354.81 | Professional | AS · PA/NP assist | $229.09 | $295.12 | $354.81 |
Where South Carolina sits
The same service costs 7.6 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 $18,140MD $2,382
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.