How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $8,511Professionalmedian $1,230 · 10th to 90th $178 to $2,042
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 $1,445.44 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,445.44 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,445.44 | $1,445.44 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,412.54 | $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 $1,318.26 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,513.56 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $3,388.44 | Facility | None | $1,000.00 | $1,445.44 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,584.89 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,071.52 Typical High $2,041.74 | Professional | None | $162.18 | $1,071.52 | $2,041.74 |
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 $1,174.90 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,412.54 | $2,454.71 |
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 $602.56 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $602.56 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $794.33 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $724.44 | $794.33 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $316.23 Typical High $549.54 | Professional | 80 · Assistant surgeon | $288.40 | $316.23 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $223.87 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $204.17 | $223.87 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $223.87 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $223.87 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $223.87 Typical High $389.05 | Professional | AS · PA/NP assist | $204.17 | $223.87 | $389.05 |
Where South Carolina sits
The same service costs 8.5 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 $16,489MD $1,943
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.