How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,188 · 10th to 90th $1,380 to $3,715
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 $1,230.27 Median $1,230.27 Typical High $7,943.28 | Facility | None | $1,230.27 | $1,230.27 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,230.27 | $2,089.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $3,890.45 | Professional | None | $1,819.70 | $2,344.23 | $3,890.45 |
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 $1,380.38 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,380.38 | $1,819.70 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $4,897.79 | Facility | None | $1,230.27 | $1,479.11 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,819.70 | $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 $1,258.93 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,258.93 | $1,905.46 | $3,388.44 |
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 $616.60 Median $616.60 Typical High $776.25 | Professional | 52 · Reduced service | $616.60 | $616.60 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $316.23 | Professional | 53 · Discontinued | $245.47 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $234.42 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $158.49 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,096.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,754.23 Typical High $5,495.41 | Professional | 50 · Both sides | $1,995.26 | $2,754.23 | $5,495.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $912.01 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $660.69 | $912.01 | $1,819.70 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $363.08 Typical High $724.44 | Professional | 80 · Assistant surgeon | $263.03 | $363.08 | $724.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $257.04 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $186.21 | $257.04 | $512.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $257.04 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $257.04 | $512.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $257.04 Typical High $512.86 | Professional | AS · PA/NP assist | $186.21 | $257.04 | $512.86 |
Where North Carolina sits
The same service costs 8.1 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 $15,945MD $1,975
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.