How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,586Professionalmedian $3,236 · 10th to 90th $1,905 to $4,677
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 $1,862.09 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,862.09 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,862.09 | $1,862.09 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $4,677.35 | Professional | None | $2,454.71 | $3,235.94 | $4,677.35 |
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 $1,995.26 Median $2,089.30 Typical High $4,677.35 | Professional | None | $1,995.26 | $2,089.30 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $4,466.84 | Professional | None | $3,019.95 | $3,019.95 | $4,466.84 |
Medcost Setting Facility Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $7,585.78 | Facility | None | $1,862.09 | $2,238.72 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $3,235.94 | Professional | None | $2,187.76 | $2,344.23 | $3,235.94 |
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 $1,621.81 Median $2,238.72 Typical High $4,677.35 | Professional | None | $1,621.81 | $2,238.72 | $4,677.35 |
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 $933.25 Median $933.25 Typical High $1,122.02 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $446.68 | Professional | 53 · Discontinued | $371.54 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,096.48 Median $1,174.90 Typical High $2,238.72 | Professional | 51 · Multiple procedures | $1,096.48 | $1,174.90 | $2,238.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $467.74 Typical High $891.25 | Professional | 80 · Assistant surgeon | $436.52 | $467.74 | $891.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $331.13 Typical High $630.96 | Professional | 81 · Minimal assistant surgeon | $302.00 | $331.13 | $630.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $331.13 Typical High $630.96 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $331.13 | $630.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $331.13 Typical High $630.96 | Professional | AS · PA/NP assist | $302.00 | $331.13 | $630.96 |
Where North Carolina sits
The same service costs 14.0 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 $34,704TX $2,477
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.