How much rates vary
Facilitymedian $1,072 · 10th to 90th $380 to $7,244Professionalmedian $3,548 · 10th to 90th $1,820 to $4,467
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 $1,778.28 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,778.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,778.28 | $1,778.28 | $2,137.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,398.83 Median $3,801.89 Typical High $4,466.84 | Professional | None | $2,398.83 | $3,801.89 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $29,512.09 | Facility | None | $478.63 | $870.96 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $4,466.84 | Professional | None | $1,862.09 | $1,949.84 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,265.80 | Professional | None | $2,951.21 | $2,951.21 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $6,606.93 | Facility | None | $1,778.28 | $2,137.96 | $6,606.93 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,238.72 | $2,884.03 |
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 $1,513.56 Median $2,137.96 Typical High $4,365.16 | Professional | None | $1,513.56 | $2,137.96 | $4,365.16 |
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 $891.25 Median $891.25 Typical High $1,047.13 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $426.58 | Professional | 53 · Discontinued | $354.81 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,479.11 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,096.48 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $1,000.00 | $1,096.48 | $2,137.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $446.68 Typical High $851.14 | Professional | 80 · Assistant surgeon | $398.11 | $446.68 | $851.14 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $309.03 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $281.84 | $309.03 | $588.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $309.03 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $309.03 | $588.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $309.03 Typical High $588.84 | Professional | AS · PA/NP assist | $281.84 | $309.03 | $588.84 |
Where North Carolina sits
The same service costs 14.4 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 $34,547MD $2,395
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.