How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $2,455 · 10th to 90th $1,585 to $4,266
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 $1,584.89 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,584.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,584.89 | $2,041.74 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,995.26 Median $2,818.38 Typical High $4,466.84 | Professional | None | $1,995.26 | $2,818.38 | $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 $1,659.59 Typical High $3,090.30 | Professional | None | $1,548.82 | $1,659.59 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,715.35 | Professional | None | $2,344.23 | $2,344.23 | $3,715.35 |
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 $1,479.11 Median $1,949.84 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,949.84 | $1,995.26 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,174.90 | $1,174.90 | $1,230.27 |
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 $1,348.96 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,621.81 | $3,019.95 |
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 $776.25 Median $776.25 Typical High $933.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 53 · Discontinued | $316.23 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $977.24 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $741.31 | $977.24 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $389.05 Typical High $426.58 | Professional | 80 · Assistant surgeon | $295.12 | $389.05 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $275.42 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $208.93 | $275.42 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $275.42 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $275.42 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $275.42 Typical High $295.12 | Professional | AS · PA/NP assist | $208.93 | $275.42 | $295.12 |
Where North Carolina sits
The same service costs 8.1 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 $17,891MD $2,222
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.