How much rates vary
Facilitymedian $1,259 · 10th to 90th $437 to $9,333Professionalmedian $1,445 · 10th to 90th $158 to $2,138
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 $1,621.81 Median $16,595.87 Typical High $37,153.52 | Facility | None | $1,621.81 | $16,595.87 | $37,153.52 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,621.81 | $2,754.23 |
Ambetter Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,621.81 | $2,454.71 |
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 $1,513.56 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,513.56 | $1,548.82 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $3,630.78 | Facility | None | $1,230.27 | $1,621.81 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,778.28 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,288.25 Typical High $2,089.30 | Professional | None | $123.03 | $1,288.25 | $2,089.30 |
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 $1,659.59 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,659.59 | $2,754.23 |
12 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 $645.65 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $194.98 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $1,148.15 | $1,148.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,691.53 Typical High $3,548.13 | Professional | 50 · Both sides | $2,454.71 | $2,691.53 | $3,548.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $891.25 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $831.76 | $891.25 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $354.81 Typical High $467.74 | Professional | 80 · Assistant surgeon | $331.13 | $354.81 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $251.19 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $229.09 | $251.19 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $251.19 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $251.19 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $251.19 Typical High $331.13 | Professional | AS · PA/NP assist | $229.09 | $251.19 | $331.13 |
Where South Carolina sits
The same service costs 14.0 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 $28,122MD $2,008
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.