How much rates vary
Facilitymedian $447 · 10th to 90th $288 to $1,445Professionalmedian $525 · 10th to 90th $355 to $1,202
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 $354.81 Median $467.74 Typical High $5,248.07 | Facility | None | $354.81 | $467.74 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $467.74 | Professional | None | $354.81 | $436.52 | $467.74 |
BCBS Setting Facility Modifier None Typical Low $234.42 Median $346.74 Typical High $467.74 | Facility | None | $234.42 | $346.74 | $467.74 |
BCBS Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $1,348.96 | Professional | None | $380.19 | $537.03 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $524.81 Typical High $851.14 | Facility | None | $363.08 | $524.81 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,071.52 | Professional | None | $467.74 | $616.60 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | None | $851.14 | $851.14 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $323.59 Typical High $1,096.48 | Facility | None | $223.87 | $323.59 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $645.65 Typical High $691.83 | Professional | None | $363.08 | $645.65 | $691.83 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $1,023.29 | Professional | None | $346.74 | $501.19 | $1,023.29 |
12 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 $177.83 Median $208.93 Typical High $234.42 | Professional | 52 · Reduced service | $177.83 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $316.23 Typical High $354.81 | Professional | 54 · Surgery only | $263.03 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $63.10 Typical High $70.79 | Professional | 55 · Aftercare only | $53.70 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $41.69 Typical High $46.77 | Professional | 56 · Pre-op care only | $35.48 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $295.12 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $245.47 | $295.12 | $331.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $102.33 Median $162.18 Typical High $537.03 | Facility | 51 · Multiple procedures | $102.33 | $162.18 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $338.84 Typical High $426.58 | Professional | 51 · Multiple procedures | $177.83 | $338.84 | $426.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $138.04 Typical High $169.82 | Professional | 80 · Assistant surgeon | $72.44 | $138.04 | $169.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $95.50 Typical High $117.49 | Professional | 81 · Minimal assistant surgeon | $50.12 | $95.50 | $117.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $95.50 Typical High $117.49 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $95.50 | $117.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $95.50 Typical High $117.49 | Professional | AS · PA/NP assist | $50.12 | $95.50 | $117.49 |
Where North Carolina sits
The same service costs 5.1 times more in Alaska 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.
North Carolina· 30th of 51
$513
AK $1,514TX $295
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.