How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $1,549 · 10th to 90th $174 to $2,239
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 $1,819.70 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,819.70 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,819.70 | $1,819.70 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,548.82 | $1,698.24 |
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 $1,548.82 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,548.82 | $1,548.82 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,862.09 | $1,995.26 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,454.71 | Facility | None | $724.44 | $724.44 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,621.81 | $1,778.28 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $1,258.93 Typical High $2,290.87 | Professional | None | $151.36 | $1,258.93 | $2,290.87 |
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 $1,318.26 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,548.82 | $2,630.27 |
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 $758.58 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $758.58 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,288.25 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $933.25 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $812.83 | $933.25 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $371.54 Typical High $446.68 | Professional | 80 · Assistant surgeon | $338.84 | $371.54 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $263.03 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $234.42 | $263.03 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $263.03 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $263.03 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $263.03 Typical High $309.03 | Professional | AS · PA/NP assist | $234.42 | $263.03 | $309.03 |
Where South Carolina sits
The same service costs 8.2 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 $17,891MD $2,184
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.