How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $3,981 · 10th to 90th $2,512 to $6,310
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 $2,398.83 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,398.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,754.23 | Professional | None | $2,398.83 | $2,398.83 | $2,754.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,090.30 Median $4,677.35 Typical High $6,456.54 | Professional | None | $3,090.30 | $4,677.35 | $6,456.54 |
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 $2,754.23 Median $3,311.31 Typical High $6,456.54 | Professional | None | $2,754.23 | $3,311.31 | $6,456.54 |
Medcost Setting Facility Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $9,120.11 | Facility | None | $2,344.23 | $2,884.03 | $9,120.11 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,884.03 | $3,162.28 | $4,365.16 |
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 $2,398.83 Median $3,388.44 Typical High $5,888.44 | Professional | None | $2,398.83 | $3,388.44 | $5,888.44 |
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 $1,202.26 Median $1,202.26 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 53 · Discontinued | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,905.46 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $4,265.80 Median $4,786.30 Typical High $10,471.29 | Professional | 50 · Both sides | $4,265.80 | $4,786.30 | $10,471.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,584.89 Typical High $3,467.37 | Professional | 51 · Multiple procedures | $1,445.44 | $1,584.89 | $3,467.37 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $630.96 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $575.44 | $630.96 | $1,380.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $446.68 Typical High $977.24 | Professional | 81 · Minimal assistant surgeon | $398.11 | $446.68 | $977.24 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $446.68 Typical High $977.24 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $446.68 | $977.24 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $446.68 Typical High $977.24 | Professional | AS · PA/NP assist | $398.11 | $446.68 | $977.24 |
Where North Carolina sits
The same service costs 13.0 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 $35,671WA $2,745
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.