How much rates vary
Facilitymedian $955 · 10th to 90th $380 to $7,244Professionalmedian $1,413 · 10th to 90th $1,000 to $2,455
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 $954.99 Median $954.99 Typical High $7,943.28 | Facility | None | $954.99 | $954.99 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,122.02 | Professional | None | $954.99 | $954.99 | $1,122.02 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,778.28 | $2,691.53 |
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 $1,023.29 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,318.26 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $3,715.35 | Facility | None | $954.99 | $1,148.15 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,202.26 | $1,737.80 |
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 $954.99 Median $1,318.26 Typical High $2,344.23 | Professional | None | $954.99 | $1,318.26 | $2,344.23 |
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 $478.63 Median $478.63 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | 53 · Discontinued | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $794.33 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $602.56 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $549.54 | $602.56 | $1,380.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $239.88 Typical High $549.54 | Professional | 80 · Assistant surgeon | $218.78 | $239.88 | $549.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $169.82 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $154.88 | $169.82 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $169.82 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $169.82 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $169.82 Typical High $389.05 | Professional | AS · PA/NP assist | $154.88 | $169.82 | $389.05 |
Where North Carolina sits
The same service costs 9.8 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 $16,204MD $1,659
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.