How much rates vary
Facilitymedian $1,622 · 10th to 90th $603 to $14,791Professionalmedian $955 · 10th to 90th $158 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 $1,071.52 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,071.52 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | None | $954.99 | $1,071.52 | $1,071.52 |
BCBS South Carolina Setting Facility Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Facility | None | $11,220.18 | $11,220.18 | $11,220.18 |
BCBS South Carolina Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,479.11 | Professional | None | $831.76 | $912.01 | $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 $1,047.13 Median $1,071.52 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,071.52 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,071.52 Typical High $2,630.27 | Facility | None | $831.76 | $1,071.52 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,258.93 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $870.96 Typical High $1,479.11 | Professional | None | $123.03 | $870.96 | $1,479.11 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $14,791.08 | Facility | None | $851.14 | $2,511.89 | $14,791.08 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,995.26 | Professional | None | $912.01 | $1,122.02 | $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 $478.63 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $707.95 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $630.96 Typical High $870.96 | Professional | 51 · Multiple procedures | $602.56 | $630.96 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $251.19 Typical High $346.74 | Professional | 80 · Assistant surgeon | $239.88 | $251.19 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $173.78 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $169.82 | $173.78 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $173.78 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $173.78 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $173.78 Typical High $239.88 | Professional | AS · PA/NP assist | $169.82 | $173.78 | $239.88 |
Where South Carolina sits
The same service costs 11.2 times more in Maine than in Delaware. 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 $23,705DE $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.