How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,047 to $15,136Professionalmedian $661 · 10th to 90th $100 to $1,072
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 $812.83 Median $10,964.78 Typical High $21,877.62 | Facility | None | $812.83 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $933.25 | Professional | None | $707.95 | $812.83 | $933.25 |
BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $4,365.16 Typical High $14,125.38 | Facility | None | $1,202.26 | $4,365.16 | $14,125.38 |
BCBS Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,230.27 | Professional | None | $630.96 | $851.14 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,691.53 | Facility | None | $602.56 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,479.11 | Professional | None | $758.58 | $776.25 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $2,041.74 Typical High $2,511.89 | Facility | None | $758.58 | $2,041.74 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,000.00 | Professional | None | $794.33 | $891.25 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $549.54 Typical High $1,071.52 | Professional | None | $87.10 | $549.54 | $1,071.52 |
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 $676.08 Median $831.76 Typical High $1,445.44 | Professional | None | $676.08 | $831.76 | $1,445.44 |
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 $363.08 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $575.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $446.68 Typical High $660.69 | Professional | 51 · Multiple procedures | $436.52 | $446.68 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $177.83 Typical High $263.03 | Professional | 80 · Assistant surgeon | $173.78 | $177.83 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $125.89 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $123.03 | $125.89 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $125.89 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $125.89 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $125.89 Typical High $186.21 | Professional | AS · PA/NP assist | $123.03 | $125.89 | $186.21 |
Where South Carolina sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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
OK $7,810KY $1,873
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.