How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $1,905 · 10th to 90th $245 to $2,818
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 $2,238.72 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,238.72 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,862.09 | $2,238.72 | $2,238.72 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $3,388.44 | Professional | None | $1,737.80 | $2,398.83 | $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 $2,089.30 Typical High $3,467.37 | Professional | None | $2,089.30 | $2,089.30 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $2,238.72 Typical High $5,248.07 | Facility | None | $1,584.89 | $2,238.72 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,570.40 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $1,513.56 Typical High $2,570.40 | Professional | None | $229.09 | $1,513.56 | $2,570.40 |
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 $1,548.82 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,548.82 | $1,995.26 | $3,235.94 |
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 $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $933.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $371.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,412.54 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,584.89 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,380.38 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $1,148.15 | $1,380.38 | $1,862.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $549.54 Typical High $741.31 | Professional | 80 · Assistant surgeon | $457.09 | $549.54 | $741.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $316.23 Median $380.19 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $316.23 | $380.19 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $316.23 Median $380.19 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $316.23 | $380.19 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $380.19 Typical High $512.86 | Professional | AS · PA/NP assist | $316.23 | $380.19 | $512.86 |
Where South Carolina sits
The same service costs 14.0 times more in Maine than in Texas. 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 $34,704TX $2,477
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.