How much rates vary
Facilitymedian $1,202 · 10th to 90th $389 to $8,318Professionalmedian $3,802 · 10th to 90th $2,291 to $6,918
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 $1,584.89 Median $2,238.72 Typical High $10,964.78 | Facility | None | $1,584.89 | $2,238.72 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $3,801.89 | Professional | None | $2,137.96 | $2,238.72 | $3,801.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,090.30 Median $5,248.07 Typical High $6,918.31 | Professional | None | $3,090.30 | $5,248.07 | $6,918.31 |
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 $2,818.38 Median $3,311.31 Typical High $6,918.31 | Professional | None | $2,818.38 | $3,311.31 | $6,918.31 |
Medcost Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,548.13 | Facility | None | $2,238.72 | $2,238.72 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $3,630.78 | Professional | None | $2,089.30 | $3,090.30 | $3,630.78 |
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 $2,290.87 Median $3,548.13 Typical High $6,025.60 | Professional | None | $2,290.87 | $3,548.13 | $6,025.60 |
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 $1,096.48 Median $1,096.48 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | 53 · Discontinued | $446.68 | $446.68 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $457.09 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $309.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,548.82 Typical High $3,235.94 | Professional | 51 · Multiple procedures | $1,047.13 | $1,548.82 | $3,235.94 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $630.96 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $416.87 | $630.96 | $1,288.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $436.52 Typical High $912.01 | Professional | 81 · Minimal assistant surgeon | $295.12 | $436.52 | $912.01 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $436.52 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $436.52 | $912.01 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $436.52 Typical High $912.01 | Professional | AS · PA/NP assist | $295.12 | $436.52 | $912.01 |
Where North Carolina sits
The same service costs 19.3 times more in Maine than in Washington. 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 $54,522WA $2,820
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.