How much rates vary
Facilitymedian $1,096 · 10th to 90th $437 to $8,511Professionalmedian $1,380 · 10th to 90th $158 to $2,042
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 $1,513.56 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,513.56 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,513.56 | $1,513.56 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,548.82 | $2,344.23 |
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 $1,380.38 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,412.54 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $3,467.37 | Facility | None | $1,096.48 | $1,513.56 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,659.59 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,202.26 Typical High $1,995.26 | Professional | None | $123.03 | $1,202.26 | $1,995.26 |
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 $1,230.27 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,548.82 | $2,570.40 |
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 $616.60 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $912.01 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $1,071.52 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $831.76 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $741.31 | $831.76 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $338.84 Typical High $446.68 | Professional | 80 · Assistant surgeon | $295.12 | $338.84 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $234.42 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $208.93 | $234.42 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $234.42 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $234.42 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $234.42 Typical High $309.03 | Professional | AS · PA/NP assist | $208.93 | $234.42 | $309.03 |
Where South Carolina sits
The same service costs 9.0 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 $17,266MD $1,911
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.