How much rates vary
Facilitymedian $1,122 · 10th to 90th $457 to $9,333Professionalmedian $1,148 · 10th to 90th $158 to $1,820
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 $1,122.02 Median $12,022.64 Typical High $21,877.62 | Facility | None | $1,122.02 | $12,022.64 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,047.13 | $1,122.02 | $1,122.02 |
BCBS South Carolina Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,949.84 | Professional | None | $977.24 | $1,288.25 | $1,949.84 |
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 $1,122.02 Median $1,230.27 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,230.27 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,951.21 | Facility | None | $912.01 | $1,122.02 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,318.26 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,096.48 Typical High $1,819.70 | Professional | None | $123.03 | $1,096.48 | $1,819.70 |
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 $1,000.00 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,258.93 | $2,187.76 |
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 $524.81 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $524.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $776.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $1,995.26 Typical High $2,884.03 | Professional | 50 · Both sides | $1,905.46 | $1,995.26 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $660.69 Typical High $954.99 | Professional | 51 · Multiple procedures | $645.65 | $660.69 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $263.03 Typical High $380.19 | Professional | 80 · Assistant surgeon | $257.04 | $263.03 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $186.21 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $177.83 | $186.21 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $186.21 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $186.21 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $186.21 Typical High $269.15 | Professional | AS · PA/NP assist | $177.83 | $186.21 | $269.15 |
Where South Carolina sits
The same service costs 16.4 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 $28,429MD $1,737
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.