How much rates vary
Facilitymedian $2,291 · 10th to 90th $724 to $16,218Professionalmedian $2,239 · 10th to 90th $1,445 to $3,981
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 $1,348.96 Median $1,778.28 Typical High $11,481.54 | Facility | None | $1,348.96 | $1,778.28 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,348.96 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,380.38 Typical High $3,548.13 | Facility | None | $891.25 | $1,380.38 | $3,548.13 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,981.07 | Professional | None | $1,737.80 | $2,570.40 | $3,981.07 |
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 $1,445.44 Median $1,445.44 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,445.44 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,235.94 | Professional | None | $2,238.72 | $2,238.72 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,187.76 | Facility | None | $724.44 | $724.44 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,548.82 | $2,089.30 |
Oscar Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,548.82 | $1,548.82 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,445.44 | $2,570.40 |
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 $676.08 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $323.59 | Professional | 53 · Discontinued | $275.42 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,122.02 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $831.76 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $645.65 | $831.76 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $338.84 Typical High $446.68 | Professional | 80 · Assistant surgeon | $257.04 | $338.84 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $239.88 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $181.97 | $239.88 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $239.88 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $239.88 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $239.88 Typical High $316.23 | Professional | AS · PA/NP assist | $181.97 | $239.88 | $316.23 |
Where North Carolina sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.