How much rates vary
Facilitymedian $891 · 10th to 90th $457 to $8,318Professionalmedian $832 · 10th to 90th $110 to $1,202
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 $912.01 Median $9,120.11 Typical High $22,908.68 | Facility | None | $912.01 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $912.01 | Professional | None | $758.58 | $912.01 | $912.01 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
BCBS South Carolina Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $933.25 | Professional | None | $707.95 | $933.25 | $933.25 |
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 $758.58 Median $776.25 Typical High $1,230.27 | Professional | None | $758.58 | $776.25 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,778.28 | Professional | None | $954.99 | $1,023.29 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $724.44 Typical High $1,230.27 | Facility | None | $630.96 | $724.44 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,071.52 | Professional | None | $870.96 | $912.01 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $741.31 Typical High $1,230.27 | Professional | None | $75.86 | $741.31 | $1,230.27 |
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 $758.58 Typical High $1,288.25 | Professional | None | $630.96 | $758.58 | $1,288.25 |
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 $380.19 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $630.96 | $630.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $457.09 Typical High $645.65 | Professional | 51 · Multiple procedures | $446.68 | $457.09 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $186.21 Typical High $263.03 | Professional | 80 · Assistant surgeon | $181.97 | $186.21 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $128.82 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $125.89 | $128.82 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $128.82 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $128.82 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $128.82 Typical High $181.97 | Professional | AS · PA/NP assist | $125.89 | $128.82 | $181.97 |
Where South Carolina sits
The same service costs 12.3 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 $16,849MD $1,375
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.