How much rates vary
Facilitymedian $2,512 · 10th to 90th $537 to $7,244Professionalmedian $1,905 · 10th to 90th $275 to $2,754
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 $2,089.30 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,089.30 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,737.80 | $2,089.30 | $2,089.30 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,698.24 Median $2,951.21 Typical High $3,162.28 | Facility | None | $1,698.24 | $2,951.21 | $3,162.28 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,621.81 | $2,041.74 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $2,238.72 Typical High $9,549.93 | Facility | None | $102.33 | $2,238.72 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,905.46 | $1,905.46 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $4,897.79 | Facility | None | $1,412.54 | $2,089.30 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,290.87 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $1,659.59 Typical High $2,570.40 | Professional | None | $229.09 | $1,659.59 | $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 $1,445.44 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,445.44 | $1,862.09 | $2,951.21 |
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 $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $870.96 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $354.81 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,318.26 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $263.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,479.11 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,288.25 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $1,047.13 | $1,288.25 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $512.86 Typical High $676.08 | Professional | 80 · Assistant surgeon | $416.87 | $512.86 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $354.81 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $295.12 | $354.81 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $354.81 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $354.81 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $354.81 Typical High $478.63 | Professional | AS · PA/NP assist | $295.12 | $354.81 | $478.63 |
Where South Carolina sits
The same service costs 14.1 times more in Maine 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
ME $34,547DE $2,454
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.