How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $8,511Professionalmedian $933 · 10th to 90th $100 to $1,514
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 $1,174.90 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,174.90 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | None | $933.25 | $1,174.90 | $1,174.90 |
BCBS South Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,778.28 | Professional | None | $851.14 | $1,202.26 | $1,778.28 |
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 $1,047.13 Median $1,096.48 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,096.48 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,174.90 Typical High $2,630.27 | Facility | None | $831.76 | $1,174.90 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,288.25 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $812.83 Typical High $1,479.11 | Professional | None | $85.11 | $812.83 | $1,479.11 |
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 $912.01 Median $1,174.90 Typical High $1,995.26 | Professional | None | $912.01 | $1,174.90 | $1,995.26 |
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 $467.74 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $467.74 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $186.21 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $93.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $812.83 | $812.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $630.96 Typical High $851.14 | Professional | 51 · Multiple procedures | $562.34 | $630.96 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $257.04 Typical High $338.84 | Professional | 80 · Assistant surgeon | $223.87 | $257.04 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $177.83 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $158.49 | $177.83 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $177.83 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $177.83 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $177.83 Typical High $239.88 | Professional | AS · PA/NP assist | $158.49 | $177.83 | $239.88 |
Where South Carolina sits
The same service costs 10.3 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 $16,837MD $1,634
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.