How much rates vary
Facilitymedian $955 · 10th to 90th $389 to $7,943Professionalmedian $1,862 · 10th to 90th $1,096 to $2,754
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 $954.99 Median $1,288.25 Typical High $8,317.64 | Facility | None | $954.99 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $2,344.23 | Professional | None | $954.99 | $954.99 | $2,344.23 |
Ambetter Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,479.11 | $2,089.30 | $2,884.03 |
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 $1,258.93 Median $1,445.44 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,445.44 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,041.74 | Facility | None | $954.99 | $1,148.15 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,584.89 | $1,905.46 |
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 $1,000.00 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,548.82 | $2,630.27 |
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 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $724.44 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $851.14 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,691.53 Typical High $4,265.80 | Professional | 50 · Both sides | $1,659.59 | $2,691.53 | $4,265.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $891.25 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $549.54 | $891.25 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $354.81 Typical High $562.34 | Professional | 80 · Assistant surgeon | $218.78 | $354.81 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $251.19 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $154.88 | $251.19 | $398.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $251.19 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $251.19 | $398.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $251.19 Typical High $398.11 | Professional | AS · PA/NP assist | $154.88 | $251.19 | $398.11 |
Where North Carolina sits
The same service costs 9.4 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 $15,900MD $1,684
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.