How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $4,571 · 10th to 90th $2,630 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 $2,511.89 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,511.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,951.21 | Professional | None | $2,511.89 | $2,511.89 | $2,951.21 |
Ambetter Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,388.44 Median $4,897.79 Typical High $6,918.31 | Professional | None | $3,388.44 | $4,897.79 | $6,918.31 |
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 $3,388.44 Typical High $6,760.83 | Professional | None | $2,754.23 | $3,388.44 | $6,760.83 |
Medcost Setting Facility Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $9,772.37 | Facility | None | $2,511.89 | $3,019.95 | $9,772.37 |
Medcost Setting Professional Modifier None Typical Low $2,951.21 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,951.21 | $3,162.28 | $4,168.69 |
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 $6,165.95 | Professional | None | $2,398.83 | $3,388.44 | $6,165.95 |
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 $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 53 · Discontinued | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $2,041.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,548.82 Typical High $3,630.78 | Professional | 51 · Multiple procedures | $1,445.44 | $1,548.82 | $3,630.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $630.96 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $588.84 | $630.96 | $1,445.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $436.52 Typical High $1,000.00 | Professional | 81 · Minimal assistant surgeon | $407.38 | $436.52 | $1,000.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $436.52 Typical High $1,000.00 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $436.52 | $1,000.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $436.52 Typical High $1,000.00 | Professional | AS · PA/NP assist | $407.38 | $436.52 | $1,000.00 |
Where North Carolina sits
The same service costs 12.3 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 $35,907WA $2,929
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.