How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,138 · 10th to 90th $1,259 to $3,311
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 $1,148.15 Median $1,148.15 Typical High $7,943.28 | Facility | None | $1,148.15 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,148.15 | $1,584.89 |
BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,621.81 | $2,398.83 | $3,548.13 |
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 $1,412.54 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,698.24 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $3,981.07 | Facility | None | $1,148.15 | $1,380.38 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,621.81 | $2,454.71 |
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 $1,174.90 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,737.80 | $3,090.30 |
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 $575.44 Median $575.44 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | 53 · Discontinued | $229.09 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $218.78 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $1,000.00 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,398.83 Typical High $5,011.87 | Professional | 50 · Both sides | $1,737.80 | $2,398.83 | $5,011.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $812.83 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $588.84 | $812.83 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $323.59 Typical High $676.08 | Professional | 80 · Assistant surgeon | $234.42 | $323.59 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $223.87 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $165.96 | $223.87 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $223.87 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $223.87 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $223.87 Typical High $467.74 | Professional | AS · PA/NP assist | $165.96 | $223.87 | $467.74 |
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 $15,824MD $1,943
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.