How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,514 · 10th to 90th $158 to $2,239
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 $1,698.24 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,698.24 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,862.09 | $2,754.23 |
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 $1,548.82 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,548.82 | $1,584.89 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $3,801.89 | Facility | None | $1,202.26 | $1,698.24 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,862.09 | $2,238.72 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,348.96 Typical High $2,187.76 | Professional | None | $123.03 | $1,348.96 | $2,187.76 |
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 $1,348.96 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,698.24 | $2,884.03 |
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 $676.08 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,174.90 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $933.25 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $812.83 | $933.25 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $371.54 Typical High $512.86 | Professional | 80 · Assistant surgeon | $331.13 | $371.54 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $263.03 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $229.09 | $263.03 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $263.03 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $263.03 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $263.03 Typical High $363.08 | Professional | AS · PA/NP assist | $229.09 | $263.03 | $363.08 |
Where South Carolina sits
The same service costs 12.0 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 $24,859MD $2,076
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.