How much rates vary
Facilitymedian $1,230 · 10th to 90th $437 to $8,710Professionalmedian $2,512 · 10th to 90th $355 to $4,169
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 $2,951.21 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,951.21 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,511.89 | $2,951.21 | $2,951.21 |
BCBS South Carolina Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $4,677.35 | Professional | None | $2,344.23 | $3,019.95 | $4,677.35 |
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 $2,818.38 Median $3,090.30 Typical High $5,623.41 | Professional | None | $2,818.38 | $3,090.30 | $5,623.41 |
Medcost Setting Facility Modifier None Typical Low $2,137.96 Median $2,951.21 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,951.21 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $4,466.84 | Professional | None | $2,884.03 | $3,388.44 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $2,187.76 Typical High $4,073.80 | Professional | None | $331.13 | $2,187.76 | $4,073.80 |
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 $2,398.83 Median $3,019.95 Typical High $5,128.61 | Professional | None | $2,398.83 | $3,019.95 | $5,128.61 |
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 $1,258.93 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,258.93 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $501.19 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,862.09 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $371.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $251.19 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,089.30 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,513.56 Median $1,698.24 Typical High $2,238.72 | Professional | 51 · Multiple procedures | $1,513.56 | $1,698.24 | $2,238.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $602.56 Median $691.83 Typical High $912.01 | Professional | 80 · Assistant surgeon | $602.56 | $691.83 | $912.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $426.58 Median $478.63 Typical High $630.96 | Professional | 81 · Minimal assistant surgeon | $426.58 | $478.63 | $630.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $426.58 Median $478.63 Typical High $630.96 | Professional | 82 · Assistant surgeon, no resident | $426.58 | $478.63 | $630.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $478.63 Typical High $630.96 | Professional | AS · PA/NP assist | $426.58 | $478.63 | $630.96 |
Where South Carolina sits
The same service costs 12.3 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 $35,907WA $2,929
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.