How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $3,162 · 10th to 90th $1,995 to $5,370
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 $1,949.84 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,949.84 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,089.30 Median $3,467.37 Typical High $5,623.41 | Professional | None | $2,089.30 | $3,467.37 | $5,623.41 |
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 $1,995.26 Median $2,089.30 Typical High $3,890.45 | Professional | None | $1,995.26 | $2,089.30 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $4,677.35 | Professional | None | $3,019.95 | $3,019.95 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $3,162.28 | Facility | None | $724.44 | $724.44 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,454.71 | Professional | None | $1,862.09 | $2,187.76 | $2,454.71 |
Oscar Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,778.28 | $1,778.28 | $1,862.09 |
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 $1,698.24 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,698.24 | $2,041.74 | $3,715.35 |
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 $977.24 Median $977.24 Typical High $1,148.15 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | 53 · Discontinued | $389.05 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $346.74 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,621.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,071.52 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $933.25 | $1,071.52 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $436.52 Typical High $524.81 | Professional | 80 · Assistant surgeon | $371.54 | $436.52 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $302.00 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $263.03 | $302.00 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $302.00 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $302.00 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $302.00 Typical High $363.08 | Professional | AS · PA/NP assist | $263.03 | $302.00 | $363.08 |
Where North Carolina sits
The same service costs 6.9 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 $18,419MD $2,652
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.