How much rates vary
Facilitymedian $1,000 · 10th to 90th $417 to $7,244Professionalmedian $1,778 · 10th to 90th $1,072 to $2,951
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 $1,071.52 Median $1,445.44 Typical High $10,964.78 | Facility | None | $1,071.52 | $1,445.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,071.52 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,202.26 | $1,905.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,905.46 | $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 $1,071.52 Median $1,148.15 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,148.15 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,659.59 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,584.89 | Facility | None | $724.44 | $724.44 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,348.96 | $1,479.11 |
Oscar Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Professional | None | $977.24 | $977.24 | $1,023.29 |
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 $933.25 Median $1,122.02 Typical High $2,041.74 | Professional | None | $933.25 | $1,122.02 | $2,041.74 |
11 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 $537.03 Median $537.03 Typical High $630.96 | Professional | 52 · Reduced service | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | 54 · Surgery only | $812.83 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $891.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $691.83 Typical High $758.58 | Professional | 51 · Multiple procedures | $512.86 | $691.83 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $275.42 Typical High $309.03 | Professional | 80 · Assistant surgeon | $204.17 | $275.42 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $190.55 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $141.25 | $190.55 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $190.55 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $190.55 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $190.55 Typical High $213.80 | Professional | AS · PA/NP assist | $141.25 | $190.55 | $213.80 |
Where North Carolina sits
The same service costs 10.1 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 $17,229MD $1,710
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.