How much rates vary
Facilitymedian $2,089 · 10th to 90th $631 to $17,378Professionalmedian $1,072 · 10th to 90th $135 to $1,778
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 $1,288.25 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,288.25 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,288.25 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
BCBS South Carolina Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $19,054.61 | Facility | None | $10,000.00 | $10,000.00 | $19,054.61 |
BCBS South Carolina Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,995.26 | Professional | None | $977.24 | $1,122.02 | $1,995.26 |
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 $1,258.93 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,258.93 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $3,162.28 | Facility | None | $1,023.29 | $1,288.25 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,513.56 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $891.25 Typical High $1,659.59 | Professional | None | $128.82 | $891.25 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $3,090.30 Typical High $18,197.01 | Facility | None | $1,023.29 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,348.96 | $2,398.83 |
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 $575.44 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $575.44 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $891.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $776.25 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $707.95 | $776.25 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $309.03 Typical High $416.87 | Professional | 80 · Assistant surgeon | $281.84 | $309.03 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $213.80 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $199.53 | $213.80 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $213.80 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $213.80 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $213.80 Typical High $288.40 | Professional | AS · PA/NP assist | $199.53 | $213.80 | $288.40 |
Where South Carolina sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.