How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $1,950 · 10th to 90th $275 to $2,951
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 $2,344.23 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,344.23 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,949.84 | $2,344.23 | $2,344.23 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,041.74 | Professional | None | $1,778.28 | $1,905.46 | $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 $1,995.26 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,995.26 | $1,995.26 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,398.83 | $2,570.40 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,162.28 | Facility | None | $724.44 | $724.44 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,290.87 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $190.55 Median $1,819.70 Typical High $3,019.95 | Professional | None | $190.55 | $1,819.70 | $3,019.95 |
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 $1,659.59 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,659.59 | $1,995.26 | $3,388.44 |
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 $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $977.24 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $389.05 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,479.11 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $295.12 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $194.98 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,659.59 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,202.26 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $1,023.29 | $1,202.26 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $478.63 Typical High $562.34 | Professional | 80 · Assistant surgeon | $436.52 | $478.63 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $331.13 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $302.00 | $331.13 | $398.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $331.13 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $331.13 | $398.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $331.13 Typical High $398.11 | Professional | AS · PA/NP assist | $302.00 | $331.13 | $398.11 |
Where South Carolina sits
The same service costs 6.9 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 $18,419MD $2,652
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.