How much rates vary
Facilitymedian $1,288 · 10th to 90th $398 to $7,943Professionalmedian $2,512 · 10th to 90th $1,380 to $3,890
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 $1,288.25 Typical High $11,220.18 | Facility | None | $1,288.25 | $1,288.25 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,288.25 | $2,344.23 |
Ambetter Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,862.09 | $1,862.09 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,630.27 | $3,890.45 |
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 $1,513.56 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,513.56 | $1,862.09 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $5,128.61 | Facility | None | $1,288.25 | $1,548.82 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,819.70 | $2,137.96 |
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 $1,698.24 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,698.24 | $3,235.94 |
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 $645.65 Median $645.65 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $245.47 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,148.15 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,884.03 Typical High $5,754.40 | Professional | 50 · Both sides | $2,454.71 | $2,884.03 | $5,754.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $954.99 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $812.83 | $954.99 | $1,905.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $389.05 Typical High $776.25 | Professional | 80 · Assistant surgeon | $323.59 | $389.05 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $269.15 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $229.09 | $269.15 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $269.15 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $269.15 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $537.03 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $537.03 |
Where North Carolina sits
The same service costs 14.0 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 $28,122MD $2,008
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.