How much rates vary
Facilitymedian $1,905 · 10th to 90th $676 to $12,882Professionalmedian $1,096 · 10th to 90th $724 to $1,950
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 $794.33 Median $1,202.26 Typical High $10,715.19 | Facility | None | $794.33 | $1,202.26 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,230.27 | Professional | None | $776.25 | $794.33 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $724.44 Median $1,445.44 Typical High $2,041.74 | Professional | None | $724.44 | $1,445.44 | $2,041.74 |
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 $851.14 Median $1,023.29 Typical High $2,041.74 | Professional | None | $851.14 | $1,023.29 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $812.83 Typical High $1,318.26 | Facility | None | $741.31 | $812.83 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,288.25 | Professional | None | $758.58 | $1,023.29 | $1,288.25 |
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 $1,047.13 Typical High $1,949.84 | Professional | None | $758.58 | $1,047.13 | $1,949.84 |
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 $398.11 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $616.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $512.86 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $380.19 | $512.86 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $204.17 Typical High $446.68 | Professional | 80 · Assistant surgeon | $151.36 | $204.17 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $144.54 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $107.15 | $144.54 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $144.54 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $144.54 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $144.54 Typical High $316.23 | Professional | AS · PA/NP assist | $107.15 | $144.54 | $316.23 |
Where North Carolina sits
The same service costs 11.6 times more in Maine than in Texas. 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 $23,484TX $2,029
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.