How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $4,467 · 10th to 90th $2,291 to $5,495
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 $2,238.72 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,238.72 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,311.31 | Professional | None | $2,238.72 | $2,238.72 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,019.95 Median $4,677.35 Typical High $5,623.41 | Professional | None | $3,019.95 | $4,677.35 | $5,623.41 |
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 $2,398.83 Median $2,511.89 Typical High $5,623.41 | Professional | None | $2,398.83 | $2,511.89 | $5,623.41 |
Medcost Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,370.32 | Professional | None | $3,715.35 | $3,715.35 | $5,370.32 |
Medcost Setting Facility Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,890.45 | Facility | None | $2,238.72 | $2,691.53 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,754.23 | $3,090.30 | $3,715.35 |
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 $5,495.41 | Professional | None | $1,949.84 | $2,691.53 | $5,495.41 |
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 $1,122.02 Median $1,122.02 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | 53 · Discontinued | $446.68 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $269.15 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,412.54 Median $1,819.70 Typical High $2,691.53 | Professional | 51 · Multiple procedures | $1,412.54 | $1,819.70 | $2,691.53 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $562.34 Median $724.44 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $562.34 | $724.44 | $1,071.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $512.86 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $398.11 | $512.86 | $758.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $512.86 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $512.86 | $758.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $512.86 Typical High $758.58 | Professional | AS · PA/NP assist | $398.11 | $512.86 | $758.58 |
Where North Carolina sits
The same service costs 12.4 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 $35,178WA $2,843
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.