How much rates vary
Facilitymedian $1,660 · 10th to 90th $447 to $5,495Professionalmedian $2,138 · 10th to 90th $1,175 to $3,388
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 $1,122.02 Median $1,288.25 Typical High $8,317.64 | Facility | None | $1,122.02 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,122.02 | $1,737.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,238.72 Median $3,235.94 Typical High $4,365.16 | Facility | None | $2,238.72 | $3,235.94 | $4,365.16 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,344.23 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,548.82 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $831.76 Typical High $2,137.96 | Facility | None | $524.81 | $831.76 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,479.11 | $1,862.09 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,445.44 | $2,754.23 |
12 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 $562.34 Median $562.34 Typical High $676.08 | Professional | 52 · Reduced service | $562.34 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $954.99 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,238.72 Typical High $4,786.30 | Professional | 50 · Both sides | $2,089.30 | $2,238.72 | $4,786.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $741.31 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $707.95 | $741.31 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $295.12 Typical High $645.65 | Professional | 80 · Assistant surgeon | $281.84 | $295.12 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $208.93 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $194.98 | $208.93 | $446.68 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $208.93 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $208.93 | $446.68 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $208.93 Typical High $446.68 | Professional | AS · PA/NP assist | $194.98 | $208.93 | $446.68 |
Where North Carolina sits
The same service costs 18.2 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 $33,172MD $1,821
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.