How much rates vary
Facilitymedian $1,259 · 10th to 90th $398 to $7,943Professionalmedian $2,692 · 10th to 90th $1,549 to $4,467
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 $1,479.11 Median $1,659.59 Typical High $10,964.78 | Facility | None | $1,479.11 | $1,659.59 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,479.11 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $4,570.88 | Professional | None | $2,344.23 | $2,951.21 | $4,570.88 |
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 $1,905.46 Median $2,187.76 Typical High $4,677.35 | Professional | None | $1,905.46 | $2,187.76 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $2,398.83 | Facility | None | $1,479.11 | $1,513.56 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,412.54 | $2,089.30 | $2,398.83 |
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 $1,513.56 Median $2,398.83 Typical High $3,981.07 | Professional | None | $1,513.56 | $2,398.83 | $3,981.07 |
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 $741.31 Median $741.31 Typical High $1,023.29 | Professional | 52 · Reduced service | $741.31 | $741.31 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | 53 · Discontinued | $295.12 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $208.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $1,047.13 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $691.83 | $1,047.13 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $416.87 Typical High $870.96 | Professional | 80 · Assistant surgeon | $281.84 | $416.87 | $870.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $288.40 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $194.98 | $288.40 | $602.56 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $288.40 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $288.40 | $602.56 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $288.40 Typical High $602.56 | Professional | AS · PA/NP assist | $194.98 | $288.40 | $602.56 |
Where North Carolina sits
The same service costs 24.1 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 $53,525MD $2,222
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.