How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,950 · 10th to 90th $275 to $3,236
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 $2,290.87 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,290.87 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $2,344.23 | Professional | None | $1,905.46 | $2,290.87 | $2,344.23 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,089.30 | $3,388.44 |
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 $2,089.30 Median $2,290.87 Typical High $4,265.80 | Professional | None | $2,089.30 | $2,290.87 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $5,370.32 | Facility | None | $1,513.56 | $2,290.87 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $3,311.31 | Professional | None | $2,041.74 | $2,398.83 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $251.19 Median $1,737.80 Typical High $3,235.94 | Professional | None | $251.19 | $1,737.80 | $3,235.94 |
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 $1,862.09 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,290.87 | $3,890.45 |
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 $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $954.99 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $380.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,445.44 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $288.40 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $190.55 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,621.81 | $1,621.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,202.26 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $1,148.15 | $1,202.26 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $478.63 Typical High $707.95 | Professional | 80 · Assistant surgeon | $457.09 | $478.63 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $338.84 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $323.59 | $338.84 | $489.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $338.84 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $338.84 | $489.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $338.84 Typical High $489.78 | Professional | AS · PA/NP assist | $323.59 | $338.84 | $489.78 |
Where South Carolina sits
The same service costs 13.8 times more in Maine than in Washington. 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 $35,114WA $2,549
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.