How much rates vary
Facilitymedian $891 · 10th to 90th $457 to $8,318Professionalmedian $1,096 · 10th to 90th $166 to $1,698
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 $1,318.26 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,318.26 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,318.26 | $1,318.26 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,096.48 | $1,258.93 |
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 $1,096.48 Median $1,096.48 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,096.48 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,348.96 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,778.28 | Facility | None | $724.44 | $724.44 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,258.93 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $1,047.13 Typical High $1,737.80 | Professional | None | $114.82 | $1,047.13 | $1,737.80 |
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 $933.25 Median $1,122.02 Typical High $1,862.09 | Professional | None | $933.25 | $1,122.02 | $1,862.09 |
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 $537.03 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $912.01 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $660.69 Typical High $812.83 | Professional | 51 · Multiple procedures | $575.44 | $660.69 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $263.03 Typical High $331.13 | Professional | 80 · Assistant surgeon | $229.09 | $263.03 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $186.21 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $158.49 | $186.21 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $186.21 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $186.21 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $229.09 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $229.09 |
Where South Carolina sits
The same service costs 10.0 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 $17,294MD $1,737
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.