How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,884 · 10th to 90th $1,549 to $4,169
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 $1,288.25 Median $1,548.82 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,548.82 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,548.82 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $4,466.84 | Professional | None | $1,905.46 | $2,884.03 | $4,466.84 |
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 $1,548.82 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,548.82 | $1,621.81 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,630.78 | Professional | None | $2,344.23 | $2,344.23 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $2,454.71 | Facility | None | $724.44 | $724.44 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,659.59 | $1,905.46 |
Oscar Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,412.54 | $1,412.54 | $1,479.11 |
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 $1,318.26 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,584.89 | $2,884.03 |
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 $758.58 Median $758.58 Typical High $912.01 | Professional | 52 · Reduced service | $758.58 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | 53 · Discontinued | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $831.76 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $724.44 | $831.76 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $407.38 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $234.42 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $204.17 | $234.42 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $234.42 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $234.42 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $234.42 Typical High $288.40 | Professional | AS · PA/NP assist | $204.17 | $234.42 | $288.40 |
Where North Carolina sits
The same service costs 8.2 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 $17,891MD $2,184
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.