How much rates vary
Facilitymedian $1,995 · 10th to 90th $631 to $16,982Professionalmedian $794 · 10th to 90th $69 to $1,230
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 $933.25 Median $9,120.11 Typical High $22,908.68 | Facility | None | $933.25 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $933.25 | Professional | None | $758.58 | $933.25 | $933.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
BCBS South Carolina Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,479.11 | Professional | None | $676.08 | $1,000.00 | $1,479.11 |
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 $851.14 Median $870.96 Typical High $1,659.59 | Professional | None | $851.14 | $870.96 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $2,089.30 | Facility | None | $676.08 | $933.25 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,148.15 | Professional | None | $870.96 | $1,023.29 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $707.95 Typical High $1,202.26 | Professional | None | $66.07 | $707.95 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,311.31 | $18,197.01 |
United Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,584.89 | Professional | None | $741.31 | $954.99 | $1,584.89 |
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 $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $660.69 | $660.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $512.86 Typical High $676.08 | Professional | 51 · Multiple procedures | $457.09 | $512.86 | $676.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $208.93 Typical High $275.42 | Professional | 80 · Assistant surgeon | $181.97 | $208.93 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $144.54 Typical High $190.55 | Professional | 81 · Minimal assistant surgeon | $125.89 | $144.54 | $190.55 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $144.54 Typical High $190.55 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $144.54 | $190.55 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $144.54 Typical High $190.55 | Professional | AS · PA/NP assist | $125.89 | $144.54 | $190.55 |
Where South Carolina sits
The same service costs 7.8 times more in Maine than in Massachusetts. 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 $16,585MA $2,122
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.