How much rates vary
Facilitymedian $2,239 · 10th to 90th $646 to $14,125Professionalmedian $1,122 · 10th to 90th $813 to $2,042
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 $758.58 Median $758.58 Typical High $7,943.28 | Facility | None | $758.58 | $758.58 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $933.25 | Professional | None | $758.58 | $758.58 | $933.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,479.11 | $2,137.96 |
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 $831.76 Median $1,071.52 Typical High $2,041.74 | Professional | None | $831.76 | $1,071.52 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $3,090.30 | Facility | None | $758.58 | $912.01 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,348.96 | Professional | None | $912.01 | $1,047.13 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,862.09 | Professional | None | $758.58 | $954.99 | $1,862.09 |
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 $380.19 Median $380.19 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $660.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $524.81 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $478.63 | $524.81 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $208.93 Typical High $436.52 | Professional | 80 · Assistant surgeon | $190.55 | $208.93 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $147.91 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $131.83 | $147.91 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $147.91 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $147.91 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $147.91 Typical High $309.03 | Professional | AS · PA/NP assist | $131.83 | $147.91 | $309.03 |
Where North Carolina sits
The same service costs 7.8 times more in Maine than in Massachusetts. 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 $16,585MA $2,122
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.