How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $2,089 · 10th to 90th $324 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 $2,511.89 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,511.89 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,511.89 | $2,511.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,659.59 | $1,905.46 |
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 $1,995.26 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,995.26 | $2,089.30 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $5,011.87 | Professional | None | $2,238.72 | $2,398.83 | $5,011.87 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,388.44 | Facility | None | $724.44 | $724.44 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $2,630.27 | Professional | None | $1,995.26 | $2,454.71 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $1,995.26 Typical High $3,311.31 | Professional | None | $229.09 | $1,995.26 | $3,311.31 |
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 $1,778.28 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,187.76 | $3,548.13 |
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 $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,047.13 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $426.58 | $501.19 | $501.19 |
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 $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $213.80 | $251.19 | $251.19 |
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 $1,000.00 Median $1,258.93 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $1,000.00 | $1,258.93 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $512.86 Typical High $616.60 | Professional | 80 · Assistant surgeon | $398.11 | $512.86 | $616.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $354.81 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $275.42 | $354.81 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $354.81 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $354.81 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $354.81 Typical High $426.58 | Professional | AS · PA/NP assist | $275.42 | $354.81 | $426.58 |
Where South Carolina sits
The same service costs 6.7 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 $18,667MD $2,801
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.