How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,586Professionalmedian $3,802 · 10th to 90th $2,089 to $5,012
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 $2,041.74 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,041.74 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,344.23 | Professional | None | $2,041.74 | $2,041.74 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,630.27 Median $4,365.16 Typical High $5,495.41 | Professional | None | $2,630.27 | $4,365.16 | $5,495.41 |
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 $2,137.96 Median $2,691.53 Typical High $5,495.41 | Professional | None | $2,137.96 | $2,691.53 | $5,495.41 |
Medcost Setting Facility Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $7,585.78 | Facility | None | $2,041.74 | $2,398.83 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $3,890.45 | Professional | None | $2,290.87 | $2,511.89 | $3,890.45 |
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 $1,949.84 Median $2,691.53 Typical High $5,011.87 | Professional | None | $1,949.84 | $2,691.53 | $5,011.87 |
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 $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | 53 · Discontinued | $407.38 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,659.59 |
Ambetter Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | AS · PA/NP assist | $323.59 | $323.59 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,122.02 Median $1,258.93 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $1,122.02 | $1,258.93 | $2,884.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $501.19 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $457.09 | $501.19 | $1,148.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $316.23 Median $346.74 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $316.23 | $346.74 | $812.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $316.23 Median $346.74 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $316.23 | $346.74 | $812.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $346.74 Typical High $812.83 | Professional | AS · PA/NP assist | $316.23 | $346.74 | $812.83 |
Where North Carolina sits
The same service costs 13.9 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 $35,243TX $2,536
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.