How much rates vary
Facilitymedian $1,122 · 10th to 90th $437 to $8,511Professionalmedian $2,239 · 10th to 90th $302 to $3,162
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 $2,187.76 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,187.76 | $2,691.53 | $2,691.53 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,041.74 | $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 $4,073.80 | Professional | None | $2,454.71 | $2,454.71 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $6,165.95 | Facility | None | $1,905.46 | $2,691.53 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $3,090.30 | Professional | None | $2,570.40 | $2,884.03 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $269.15 Median $1,862.09 Typical High $3,090.30 | Professional | None | $269.15 | $1,862.09 | $3,090.30 |
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 $1,819.70 Median $2,344.23 Typical High $3,801.89 | Professional | None | $1,819.70 | $2,344.23 | $3,801.89 |
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 $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,096.48 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $436.52 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,659.59 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $218.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,862.09 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,348.96 Median $1,548.82 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $1,348.96 | $1,548.82 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $616.60 Typical High $812.83 | Professional | 80 · Assistant surgeon | $537.03 | $616.60 | $812.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $426.58 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $380.19 | $426.58 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $426.58 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $426.58 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $426.58 Typical High $562.34 | Professional | AS · PA/NP assist | $380.19 | $426.58 | $562.34 |
Where South Carolina sits
The same service costs 13.8 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 $35,114TX $2,545
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.