How much rates vary
Facilitymedian $912 · 10th to 90th $316 to $6,026Professionalmedian $1,380 · 10th to 90th $158 to $2,188
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 $1,548.82 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,548.82 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,548.82 | $1,548.82 |
BCBS South Carolina Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,096.48 | $1,995.26 | $3,090.30 |
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 $1,445.44 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,445.44 | $1,479.11 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,122.02 | $1,548.82 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,513.56 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,230.27 Typical High $2,041.74 | Professional | None | $123.03 | $1,230.27 | $2,041.74 |
United Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $6,025.60 | Facility | None | $302.00 | $741.31 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,584.89 | $2,630.27 |
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 $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $616.60 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $933.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $186.21 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $870.96 | $1,096.48 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $794.33 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $676.08 | $794.33 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $323.59 Typical High $446.68 | Professional | 80 · Assistant surgeon | $269.15 | $323.59 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $223.87 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $186.21 | $223.87 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $223.87 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $223.87 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $223.87 Typical High $316.23 | Professional | AS · PA/NP assist | $186.21 | $223.87 | $316.23 |
Where South Carolina sits
The same service costs 13.1 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 $24,687MD $1,882
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.