How much rates vary
Facilitymedian $1,072 · 10th to 90th $437 to $8,511Professionalmedian $1,230 · 10th to 90th $158 to $1,950
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 $1,148.15 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,148.15 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,148.15 | $1,148.15 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,621.81 | $2,238.72 |
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 $1,230.27 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,348.96 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $3,019.95 | Facility | None | $1,071.52 | $1,148.15 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,479.11 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,148.15 Typical High $1,905.46 | Professional | None | $123.03 | $1,148.15 | $1,905.46 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,258.93 Typical High $8,709.64 | Facility | None | $416.87 | $1,258.93 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,348.96 | $2,238.72 |
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 $549.54 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $812.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $741.31 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $724.44 | $741.31 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $295.12 Typical High $407.38 | Professional | 80 · Assistant surgeon | $288.40 | $295.12 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $208.93 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $199.53 | $208.93 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $208.93 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $208.93 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $208.93 Typical High $281.84 | Professional | AS · PA/NP assist | $199.53 | $208.93 | $281.84 |
Where South Carolina sits
The same service costs 15.4 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 $28,500MD $1,851
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.