How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $5,888 · 10th to 90th $3,715 to $9,120
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 $3,630.78 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $5,248.07 | Professional | None | $3,630.78 | $3,630.78 | $5,248.07 |
Ambetter Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $4,786.30 Median $6,760.83 Typical High $10,000.00 | Professional | None | $4,786.30 | $6,760.83 | $10,000.00 |
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 $4,073.80 Median $4,897.79 Typical High $9,772.37 | Professional | None | $4,073.80 | $4,897.79 | $9,772.37 |
Medcost Setting Facility Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $14,125.38 | Facility | None | $3,630.78 | $4,365.16 | $14,125.38 |
Medcost Setting Professional Modifier None Typical Low $4,365.16 Median $4,570.88 Typical High $5,888.44 | Professional | None | $4,365.16 | $4,570.88 | $5,888.44 |
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 $3,548.13 Median $4,897.79 Typical High $8,912.51 | Professional | None | $3,548.13 | $4,897.79 | $8,912.51 |
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 $1,819.70 Median $1,819.70 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,819.70 | $1,819.70 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | 53 · Discontinued | $724.44 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 55 · Aftercare only | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 56 · Pre-op care only | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $2,187.76 Median $2,290.87 Typical High $5,248.07 | Professional | 51 · Multiple procedures | $2,187.76 | $2,290.87 | $5,248.07 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $891.25 Median $912.01 Typical High $2,089.30 | Professional | 80 · Assistant surgeon | $891.25 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $616.60 Median $645.65 Typical High $1,479.11 | Professional | 81 · Minimal assistant surgeon | $616.60 | $645.65 | $1,479.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $616.60 Median $645.65 Typical High $1,479.11 | Professional | 82 · Assistant surgeon, no resident | $616.60 | $645.65 | $1,479.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $616.60 Median $645.65 Typical High $1,479.11 | Professional | AS · PA/NP assist | $616.60 | $645.65 | $1,479.11 |
Where North Carolina sits
The same service costs 9.9 times more in Maine than in Washington. 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 $37,607WA $3,801
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.