How much rates vary
Facilitymedian $912 · 10th to 90th $457 to $8,318Professionalmedian $871 · 10th to 90th $110 to $1,349
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 $1,047.13 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,047.13 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | None | $870.96 | $1,047.13 | $1,047.13 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
BCBS South Carolina Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $870.96 | Professional | None | $776.25 | $812.83 | $870.96 |
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 $870.96 Median $870.96 Typical High $1,412.54 | Professional | None | $870.96 | $870.96 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $2,041.74 | Professional | None | $1,000.00 | $1,071.52 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $724.44 Typical High $1,412.54 | Facility | None | $660.69 | $724.44 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | None | $933.25 | $1,023.29 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $831.76 Typical High $1,380.38 | Professional | None | $75.86 | $831.76 | $1,380.38 |
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 $741.31 Median $891.25 Typical High $1,479.11 | Professional | None | $741.31 | $891.25 | $1,479.11 |
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 $436.52 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $724.44 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $524.81 Typical High $630.96 | Professional | 51 · Multiple procedures | $467.74 | $524.81 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $213.80 Typical High $251.19 | Professional | 80 · Assistant surgeon | $186.21 | $213.80 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $147.91 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $131.83 | $147.91 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $147.91 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $147.91 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $147.91 Typical High $177.83 | Professional | AS · PA/NP assist | $131.83 | $147.91 | $177.83 |
Where South Carolina sits
The same service costs 11.4 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 $16,997MD $1,496
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.