How much rates vary
Facilitymedian $2,455 · 10th to 90th $724 to $20,417Professionalmedian $1,445 · 10th to 90th $224 to $2,089
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 $1,621.81 Median $14,791.08 Typical High $24,547.09 | Facility | None | $1,621.81 | $14,791.08 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,621.81 | $1,698.24 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,621.81 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $851.14 Typical High $1,905.46 | Facility | None | $100.00 | $851.14 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,380.38 | $1,445.44 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,737.80 | $1,862.09 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,187.76 | Facility | None | $724.44 | $724.44 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,659.59 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,258.93 Typical High $2,137.96 | Professional | None | $151.36 | $1,258.93 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $21,379.62 | Facility | None | $1,445.44 | $3,715.35 | $21,379.62 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,412.54 | $2,398.83 |
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 $676.08 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,023.29 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $954.99 | $1,148.15 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $851.14 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $776.25 | $851.14 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $338.84 Typical High $501.19 | Professional | 80 · Assistant surgeon | $309.03 | $338.84 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $239.88 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $218.78 | $239.88 | $346.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $239.88 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $239.88 | $346.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $239.88 Typical High $346.74 | Professional | AS · PA/NP assist | $218.78 | $239.88 | $346.74 |
Where South Carolina sits
The same service costs 8.5 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 $28,081DE $3,299
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.