How much rates vary
Facilitymedian $832 · 10th to 90th $282 to $7,244Professionalmedian $219 · 10th to 90th $132 to $389
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 $128.82 Median $128.82 Typical High $7,943.28 | Facility | None | $128.82 | $128.82 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $173.78 | Professional | None | $123.03 | $128.82 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $208.93 | Professional | None | $190.55 | $190.55 | $208.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $398.11 | Professional | None | $186.21 | $302.00 | $398.11 |
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 $162.18 Median $190.55 Typical High $398.11 | Professional | None | $162.18 | $190.55 | $398.11 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $204.17 | Facility | None | $128.82 | $128.82 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $204.17 | Professional | None | $120.23 | $165.96 | $204.17 |
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 $131.83 Median $204.17 Typical High $346.74 | Professional | None | $131.83 | $204.17 | $346.74 |
10 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 $63.10 Median $63.10 Typical High $81.28 | Professional | 52 · Reduced service | $63.10 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $32.36 | Professional | 53 · Discontinued | $25.70 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | 54 · Surgery only | $95.50 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $16.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $83.18 Typical High $173.78 | Professional | 51 · Multiple procedures | $60.26 | $83.18 | $173.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.99 Median $33.11 Typical High $69.18 | Professional | 80 · Assistant surgeon | $23.99 | $33.11 | $69.18 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $16.98 Median $22.91 Typical High $48.98 | Professional | 81 · Minimal assistant surgeon | $16.98 | $22.91 | $48.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $16.98 Median $22.91 Typical High $48.98 | Professional | 82 · Assistant surgeon, no resident | $16.98 | $22.91 | $48.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $22.91 Typical High $48.98 | Professional | AS · PA/NP assist | $16.98 | $22.91 | $48.98 |
Where North Carolina sits
The same service costs 262.6 times more in Maine than in Montana. 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 $102,516MT $390
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.