How much rates vary
Facilitymedian $832 · 10th to 90th $282 to $7,244Professionalmedian $479 · 10th to 90th $269 to $676
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 $263.03 Median $263.03 Typical High $7,943.28 | Facility | None | $263.03 | $263.03 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $389.05 | Professional | None | $263.03 | $263.03 | $389.05 |
BCBS North Carolina Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $707.95 | Professional | None | $331.13 | $489.78 | $707.95 |
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 $295.12 Median $363.08 Typical High $707.95 | Professional | None | $295.12 | $363.08 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $1,096.48 | Facility | None | $263.03 | $316.23 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $478.63 | Professional | None | $295.12 | $338.84 | $478.63 |
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 $251.19 Median $338.84 Typical High $630.96 | Professional | None | $251.19 | $338.84 | $630.96 |
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 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 52 · Reduced service | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $60.26 | Professional | 53 · Discontinued | $52.48 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | 54 · Surgery only | $194.98 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $30.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $165.96 Typical High $380.19 | Professional | 51 · Multiple procedures | $158.49 | $165.96 | $380.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $67.61 Typical High $151.36 | Professional | 80 · Assistant surgeon | $63.10 | $67.61 | $151.36 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $44.67 Median $46.77 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $44.67 | $46.77 | $107.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $44.67 Median $46.77 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $44.67 | $46.77 | $107.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $46.77 Typical High $107.15 | Professional | AS · PA/NP assist | $44.67 | $46.77 | $107.15 |
Where North Carolina sits
The same service costs 32.0 times more in Maine than in Montana. 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 $26,674MT $834
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.