How much rates vary
Facilitymedian $1,000 · 10th to 90th $437 to $8,511Professionalmedian $1,122 · 10th to 90th $178 to $1,862
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 $1,318.26 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,318.26 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,318.26 | $1,318.26 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,318.26 | $2,187.76 |
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 $1,380.38 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,380.38 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,318.26 Typical High $3,162.28 | Facility | None | $912.01 | $1,318.26 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,445.44 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $977.24 Typical High $1,862.09 | Professional | None | $162.18 | $977.24 | $1,862.09 |
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 $1,071.52 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,318.26 | $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 $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $549.54 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $933.25 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $724.44 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $660.69 | $724.44 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $288.40 Typical High $426.58 | Professional | 80 · Assistant surgeon | $263.03 | $288.40 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $204.17 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $186.21 | $204.17 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $204.17 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $204.17 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $204.17 Typical High $302.00 | Professional | AS · PA/NP assist | $186.21 | $204.17 | $302.00 |
Where South Carolina sits
The same service costs 8.8 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 $16,376MD $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.