How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,514 to $20,893Professionalmedian $2,754 · 10th to 90th $363 to $3,981
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 $3,235.94 Median $9,120.11 Typical High $22,908.68 | Facility | None | $3,235.94 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,691.53 | $3,235.94 | $3,235.94 |
BCBS 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 Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $3,981.07 | Professional | None | $2,511.89 | $3,019.95 | $3,981.07 |
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 $2,951.21 Median $2,951.21 Typical High $5,011.87 | Professional | None | $2,951.21 | $2,951.21 | $5,011.87 |
Medcost Setting Facility Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $7,585.78 | Facility | None | $2,187.76 | $3,235.94 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,235.94 Typical High $3,715.35 | Professional | None | $3,019.95 | $3,235.94 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $2,290.87 Typical High $3,801.89 | Professional | None | $331.13 | $2,290.87 | $3,801.89 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $10,471.29 Typical High $28,840.32 | Facility | None | $3,311.31 | $10,471.29 | $28,840.32 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $4,570.88 | Professional | None | $2,238.72 | $2,884.03 | $4,570.88 |
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 $1,348.96 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,348.96 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $549.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,041.74 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,238.72 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,513.56 Median $1,778.28 Typical High $2,454.71 | Professional | 51 · Multiple procedures | $1,513.56 | $1,778.28 | $2,454.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $602.56 Median $707.95 Typical High $977.24 | Professional | 80 · Assistant surgeon | $602.56 | $707.95 | $977.24 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $426.58 Median $489.78 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $426.58 | $489.78 | $691.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $426.58 Median $489.78 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $426.58 | $489.78 | $691.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $489.78 Typical High $691.83 | Professional | AS · PA/NP assist | $426.58 | $489.78 | $691.83 |
Where South Carolina sits
The same service costs 6.3 times more in Maine than in South Carolina. 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 $35,748SC $5,705
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.