How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,042 · 10th to 90th $1,230 to $3,090
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 $1,096.48 Median $1,096.48 Typical High $7,943.28 | Facility | None | $1,096.48 | $1,096.48 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,096.48 | $1,412.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $3,090.30 | Professional | None | $1,548.82 | $2,344.23 | $3,090.30 |
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 $1,659.59 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,659.59 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,238.72 | Facility | None | $1,096.48 | $1,318.26 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,778.28 | $2,344.23 |
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 $1,122.02 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,122.02 | $1,659.59 | $3,019.95 |
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 $549.54 Median $549.54 Typical High $691.83 | Professional | 52 · Reduced service | $549.54 | $549.54 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $977.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,951.21 Typical High $4,897.79 | Professional | 50 · Both sides | $1,548.82 | $2,951.21 | $4,897.79 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $977.24 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $524.81 | $977.24 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $398.11 Typical High $645.65 | Professional | 80 · Assistant surgeon | $208.93 | $398.11 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $275.42 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $144.54 | $275.42 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $275.42 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $275.42 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $275.42 Typical High $457.09 | Professional | AS · PA/NP assist | $144.54 | $275.42 | $457.09 |
Where North Carolina sits
The same service costs 8.2 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 $15,747MD $1,911
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.