How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $3,388 · 10th to 90th $1,862 to $4,467
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 $1,288.25 Median $1,819.70 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,819.70 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $4,897.79 | Professional | None | $2,344.23 | $3,630.78 | $4,897.79 |
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 $1,905.46 Median $2,398.83 Typical High $4,897.79 | Professional | None | $1,905.46 | $2,398.83 | $4,897.79 |
Medcost Setting Facility Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $6,918.31 | Facility | None | $1,819.70 | $2,187.76 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $3,019.95 | Professional | None | $2,041.74 | $2,238.72 | $3,019.95 |
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 $1,737.80 Median $2,454.71 Typical High $4,466.84 | Professional | None | $1,737.80 | $2,454.71 | $4,466.84 |
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 $912.01 Median $912.01 Typical High $1,047.13 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 53 · Discontinued | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $208.93 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,122.02 Typical High $2,630.27 | Professional | 51 · Multiple procedures | $1,000.00 | $1,122.02 | $2,630.27 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $446.68 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $407.38 | $446.68 | $1,047.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $309.03 Typical High $724.44 | Professional | 81 · Minimal assistant surgeon | $281.84 | $309.03 | $724.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $309.03 Typical High $724.44 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $309.03 | $724.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $309.03 Typical High $724.44 | Professional | AS · PA/NP assist | $281.84 | $309.03 | $724.44 |
Where North Carolina sits
The same service costs 13.4 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 $34,930MD $2,604
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.