How much rates vary
Facilitymedian $891 · 10th to 90th $457 to $8,318Professionalmedian $741 · 10th to 90th $110 to $1,175
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 $933.25 Median $9,120.11 Typical High $22,908.68 | Facility | None | $933.25 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $933.25 | Professional | None | $776.25 | $933.25 | $933.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
BCBS South Carolina Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $758.58 | Professional | None | $645.65 | $707.95 | $758.58 |
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 $741.31 Median $741.31 Typical High $1,258.93 | Professional | None | $741.31 | $741.31 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,819.70 | Professional | None | $831.76 | $891.25 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $724.44 Typical High $1,258.93 | Facility | None | $549.54 | $724.44 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $933.25 | Professional | None | $741.31 | $891.25 | $933.25 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $724.44 Typical High $1,202.26 | Professional | None | $75.86 | $724.44 | $1,202.26 |
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 $630.96 Median $794.33 Typical High $1,318.26 | Professional | None | $630.96 | $794.33 | $1,318.26 |
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 $389.05 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $645.65 | $645.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $457.09 Typical High $562.34 | Professional | 51 · Multiple procedures | $371.54 | $457.09 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $181.97 Typical High $223.87 | Professional | 80 · Assistant surgeon | $147.91 | $181.97 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $128.82 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $102.33 | $128.82 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $128.82 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $128.82 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $158.49 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $158.49 |
Where South Carolina sits
The same service costs 6.1 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 $8,436MD $1,394
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.