How much rates vary
Facilitymedian $871 · 10th to 90th $389 to $7,943Professionalmedian $1,349 · 10th to 90th $794 to $2,399
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 $776.25 Median $1,584.89 Typical High $10,471.29 | Facility | None | $776.25 | $1,584.89 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,584.89 | Professional | None | $776.25 | $776.25 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,819.70 | $2,398.83 |
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 $977.24 Median $1,148.15 Typical High $2,398.83 | Professional | None | $977.24 | $1,148.15 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $794.33 Typical High $1,230.27 | Facility | None | $776.25 | $794.33 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,258.93 | Professional | None | $724.44 | $1,096.48 | $1,258.93 |
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 $794.33 Median $1,258.93 Typical High $2,089.30 | Professional | None | $794.33 | $1,258.93 | $2,089.30 |
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 $389.05 Median $389.05 Typical High $537.03 | Professional | 52 · Reduced service | $389.05 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $213.80 | Professional | 53 · Discontinued | $154.88 | $154.88 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $812.83 | Professional | 54 · Surgery only | $575.44 | $575.44 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $162.18 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $107.15 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $537.03 Typical High $1,148.15 | Professional | 51 · Multiple procedures | $363.08 | $537.03 | $1,148.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $218.78 Typical High $457.09 | Professional | 80 · Assistant surgeon | $144.54 | $218.78 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $151.36 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $102.33 | $151.36 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $151.36 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $151.36 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $151.36 Typical High $316.23 | Professional | AS · PA/NP assist | $102.33 | $151.36 | $316.23 |
Where North Carolina sits
The same service costs 18.7 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 $26,826MD $1,433
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.