How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $4,074 · 10th to 90th $2,239 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 $2,187.76 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,187.76 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,691.53 | Professional | None | $2,187.76 | $2,187.76 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,951.21 Median $4,073.80 Typical High $5,495.41 | Professional | None | $2,951.21 | $4,073.80 | $5,495.41 |
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 $5,495.41 | Professional | None | $2,398.83 | $2,511.89 | $5,495.41 |
Medcost Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,248.07 | Professional | None | $3,715.35 | $3,715.35 | $5,248.07 |
Medcost Setting Facility Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $3,890.45 | Facility | None | $2,187.76 | $2,630.27 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $3,630.78 | Professional | None | $2,691.53 | $3,090.30 | $3,630.78 |
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 $1,905.46 Median $2,630.27 Typical High $5,495.41 | Professional | None | $1,905.46 | $2,630.27 | $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 $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $537.03 | Professional | 53 · Discontinued | $436.52 | $436.52 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,380.38 Median $1,819.70 Typical High $2,691.53 | Professional | 51 · Multiple procedures | $1,380.38 | $1,819.70 | $2,691.53 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $724.44 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $549.54 | $724.44 | $1,071.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $389.05 Median $512.86 Typical High $741.31 | Professional | 81 · Minimal assistant surgeon | $389.05 | $512.86 | $741.31 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $389.05 Median $512.86 Typical High $741.31 | Professional | 82 · Assistant surgeon, no resident | $389.05 | $512.86 | $741.31 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $512.86 Typical High $741.31 | Professional | AS · PA/NP assist | $389.05 | $512.86 | $741.31 |
Where North Carolina sits
The same service costs 13.8 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 $35,114TX $2,545
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.