How much rates vary
Facilitymedian $2,512 · 10th to 90th $234 to $17,378Professionalmedian $282 · 10th to 90th $209 to $490
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 $281.84 Median $10,964.78 Typical High $21,877.62 | Facility | None | $281.84 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | None | $234.42 | $281.84 | $281.84 |
BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $2,951.21 Typical High $19,054.61 | Facility | None | $1,737.80 | $2,951.21 | $19,054.61 |
BCBS Setting Professional Modifier None Typical Low $208.93 Median $446.68 Typical High $562.34 | Professional | None | $208.93 | $446.68 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $870.96 Typical High $1,995.26 | Facility | None | $588.84 | $870.96 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $512.86 | Professional | None | $281.84 | $288.40 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $309.03 Typical High $5,754.40 | Facility | None | $234.42 | $309.03 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $537.03 | Professional | None | $275.42 | $363.08 | $537.03 |
Molina Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $354.81 | Professional | None | $194.98 | $245.47 | $354.81 |
United Setting Facility Modifier None Typical Low $85.11 Median $912.01 Typical High $4,677.35 | Facility | None | $85.11 | $912.01 | $4,677.35 |
United Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $416.87 | Professional | None | $199.53 | $257.04 | $416.87 |
10 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 $117.49 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $177.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $35.48 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $28.18 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $186.21 Typical High $269.15 | Professional | 51 · Multiple procedures | $151.36 | $186.21 | $269.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $74.13 Typical High $109.65 | Professional | 80 · Assistant surgeon | $60.26 | $74.13 | $109.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $52.48 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $42.66 | $52.48 | $75.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $52.48 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $52.48 | $75.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $52.48 Typical High $75.86 | Professional | AS · PA/NP assist | $42.66 | $52.48 | $75.86 |
Where South Carolina sits
The same service costs 43.2 times more in Michigan than in Delaware. 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
MI $17,702DE $410
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.