How much rates vary
Facilitymedian $1,175 · 10th to 90th $398 to $10,471Professionalmedian $2,188 · 10th to 90th $1,259 to $3,467
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 $1,174.90 Median $1,584.89 Typical High $11,481.54 | Facility | None | $1,174.90 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,174.90 | $2,041.74 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,584.89 | $2,344.23 | $3,548.13 |
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 $1,318.26 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,621.81 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $4,365.16 | Facility | None | $1,174.90 | $1,412.54 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,621.81 | $1,949.84 |
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 $1,174.90 Median $1,479.11 Typical High $2,951.21 | Professional | None | $1,174.90 | $1,479.11 | $2,951.21 |
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 $588.84 Median $588.84 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $295.12 | Professional | 53 · Discontinued | $234.42 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,096.48 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $218.78 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $147.91 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,023.29 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,454.71 Typical High $5,128.61 | Professional | 50 · Both sides | $2,089.30 | $2,454.71 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $812.83 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $691.83 | $812.83 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $323.59 Typical High $691.83 | Professional | 80 · Assistant surgeon | $275.42 | $323.59 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $229.09 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $194.98 | $229.09 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $229.09 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $229.09 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $229.09 Typical High $478.63 | Professional | AS · PA/NP assist | $194.98 | $229.09 | $478.63 |
Where North Carolina sits
The same service costs 14.8 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 $28,001MD $1,894
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.