How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,288 to $26,303Professionalmedian $5,129 · 10th to 90th $2,754 to $6,607
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 $2,630.27 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,630.27 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,311.31 | Professional | None | $2,630.27 | $2,630.27 | $3,311.31 |
BCBS Setting Professional Modifier None Typical Low $3,467.37 Median $5,128.61 Typical High $6,606.93 | Professional | None | $3,467.37 | $5,128.61 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,630.27 Typical High $29,512.09 | Facility | None | $489.78 | $2,630.27 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $6,606.93 | Professional | None | $2,754.23 | $2,884.03 | $6,606.93 |
Medcost Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $6,309.57 | Professional | None | $4,466.84 | $4,466.84 | $6,309.57 |
Medcost Setting Facility Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $9,772.37 | Facility | None | $2,630.27 | $3,162.28 | $9,772.37 |
Medcost Setting Professional Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $4,365.16 | Professional | None | $2,951.21 | $3,311.31 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $6,456.54 | Professional | None | $2,290.87 | $3,162.28 | $6,456.54 |
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 $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 53 · Discontinued | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,479.11 Median $1,659.59 Typical High $3,162.28 | Professional | 51 · Multiple procedures | $1,479.11 | $1,659.59 | $3,162.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $660.69 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $588.84 | $660.69 | $1,258.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $416.87 Median $457.09 Typical High $891.25 | Professional | 81 · Minimal assistant surgeon | $416.87 | $457.09 | $891.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $416.87 Median $457.09 Typical High $891.25 | Professional | 82 · Assistant surgeon, no resident | $416.87 | $457.09 | $891.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $457.09 Typical High $891.25 | Professional | AS · PA/NP assist | $416.87 | $457.09 | $891.25 |
Where North Carolina sits
The same service costs 6.0 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 $35,671TX $5,942
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.