How much rates vary
Facilitymedian $1,230 · 10th to 90th $437 to $8,511Professionalmedian $1,950 · 10th to 90th $275 to $2,692
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 $2,137.96 Median $9,120.11 Typical High $22,908.68 | Facility | None | $2,137.96 | $9,120.11 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,778.28 | $2,137.96 | $2,137.96 |
BCBS South Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,659.59 | $1,995.26 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,995.26 | Facility | None | $100.00 | $794.33 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,949.84 | $1,949.84 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $4,897.79 | Facility | None | $1,479.11 | $2,137.96 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,344.23 | $2,818.38 |
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 $1,479.11 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,905.46 | $3,019.95 |
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 $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $891.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $354.81 | $426.58 | $426.58 |
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 $177.83 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $177.83 | $213.80 | $213.80 |
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 $1,071.52 Median $1,202.26 Typical High $1,584.89 | Professional | 51 · Multiple procedures | $1,071.52 | $1,202.26 | $1,584.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $478.63 Typical High $645.65 | Professional | 80 · Assistant surgeon | $426.58 | $478.63 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $338.84 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $302.00 | $338.84 | $446.68 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $338.84 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $338.84 | $446.68 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $338.84 Typical High $446.68 | Professional | AS · PA/NP assist | $302.00 | $338.84 | $446.68 |
Where South Carolina sits
The same service costs 14.4 times more in Maine than in Maryland. 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 $34,547MD $2,395
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.