How much rates vary
Facilitymedian $2,188 · 10th to 90th $661 to $16,982Professionalmedian $776 · 10th to 90th $158 to $1,259
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 $891.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $891.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,148.15 | Professional | None | $776.25 | $891.25 | $1,148.15 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2,344.23 Median $3,311.31 Typical High $7,079.46 | Facility | None | $2,344.23 | $3,311.31 | $7,079.46 |
BCBS South Carolina Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,047.13 | Professional | None | $660.69 | $707.95 | $1,047.13 |
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 $812.83 Median $870.96 Typical High $1,621.81 | Professional | None | $812.83 | $870.96 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $891.25 Typical High $1,202.26 | Facility | None | $660.69 | $891.25 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,230.27 | Professional | None | $912.01 | $1,000.00 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $741.31 Typical High $1,258.93 | Professional | None | $123.03 | $741.31 | $1,258.93 |
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 $758.58 Median $933.25 Typical High $1,621.81 | Professional | None | $758.58 | $933.25 | $1,621.81 |
12 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 $398.11 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $616.60 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 59 · Distinct service | $977.24 | $977.24 | $977.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $501.19 Typical High $707.95 | Professional | 51 · Multiple procedures | $457.09 | $501.19 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $199.53 Typical High $288.40 | Professional | 80 · Assistant surgeon | $181.97 | $199.53 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $138.04 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $128.82 | $138.04 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $138.04 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $138.04 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $138.04 Typical High $199.53 | Professional | AS · PA/NP assist | $128.82 | $138.04 | $199.53 |
Where South Carolina sits
The same service costs 11.6 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 $23,484TX $2,029
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.