How much rates vary
Facilitymedian $832 · 10th to 90th $380 to $7,244Professionalmedian $1,072 · 10th to 90th $741 to $1,862
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 $691.83 Median $691.83 Typical High $7,943.28 | Facility | None | $691.83 | $691.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $912.01 | Professional | None | $691.83 | $691.83 | $912.01 |
BCBS North Carolina Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,995.26 | Professional | None | $954.99 | $1,348.96 | $1,995.26 |
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 $741.31 Median $977.24 Typical High $1,905.46 | Professional | None | $741.31 | $977.24 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $831.76 Typical High $2,818.38 | Facility | None | $691.83 | $831.76 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,258.93 | Professional | None | $851.14 | $954.99 | $1,258.93 |
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 $707.95 Median $870.96 Typical High $1,737.80 | Professional | None | $707.95 | $870.96 | $1,737.80 |
12 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 $346.74 Median $346.74 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $676.08 | Professional | 54 · Surgery only | $512.86 | $512.86 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $134.90 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $630.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,445.44 Typical High $3,162.28 | Professional | 50 · Both sides | $1,288.25 | $1,445.44 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $478.63 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $426.58 | $478.63 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $190.55 Typical High $416.87 | Professional | 80 · Assistant surgeon | $169.82 | $190.55 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $134.90 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $120.23 | $134.90 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $134.90 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $134.90 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $134.90 Typical High $295.12 | Professional | AS · PA/NP assist | $120.23 | $134.90 | $295.12 |
Where North Carolina sits
The same service costs 17.6 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 $23,909MD $1,357
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.