How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $2,291 · 10th to 90th $302 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 $2,691.53 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,691.53 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,238.72 | $2,691.53 | $2,691.53 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,089.30 | $2,398.83 | $3,162.28 |
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 $2,454.71 Median $2,454.71 Typical High $4,168.69 | Professional | None | $2,454.71 | $2,454.71 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $6,309.57 | Facility | None | $1,905.46 | $2,691.53 | $6,309.57 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,630.27 | $2,951.21 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $1,862.09 Typical High $3,162.28 | Professional | None | $269.15 | $1,862.09 | $3,162.28 |
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 $2,398.83 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,398.83 | $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 $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,122.02 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,698.24 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,905.46 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,380.38 Median $1,548.82 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $1,380.38 | $1,548.82 | $2,041.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $616.60 Typical High $812.83 | Professional | 80 · Assistant surgeon | $549.54 | $616.60 | $812.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $380.19 | $426.58 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $426.58 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $426.58 Typical High $575.44 | Professional | AS · PA/NP assist | $380.19 | $426.58 | $575.44 |
Where South Carolina sits
The same service costs 12.4 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 $35,178WA $2,843
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.