How much rates vary
Facilitymedian $204 · 10th to 90th $71 to $1,349Professionalmedian $200 · 10th to 90th $62 to $407
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 $48.98 Median $165.96 Typical High $5,495.41 | Facility | None | $48.98 | $165.96 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $144.54 Typical High $204.17 | Professional | None | $48.98 | $144.54 | $204.17 |
BCBS North Carolina Setting Professional Modifier None Typical Low $81.28 Median $281.84 Typical High $436.52 | Professional | None | $81.28 | $281.84 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $602.56 Typical High $1,995.26 | Facility | None | $501.19 | $602.56 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $190.55 Typical High $331.13 | Professional | None | $61.66 | $190.55 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $48.98 Median $263.03 Typical High $302.00 | Facility | None | $48.98 | $263.03 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $275.42 | Professional | None | $186.21 | $223.87 | $275.42 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $51.29 Median $144.54 Typical High $331.13 | Professional | None | $51.29 | $144.54 | $331.13 |
10 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 $24.55 Median $31.62 Typical High $83.18 | Professional | 52 · Reduced service | $24.55 | $31.62 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.59 Typical High $33.11 | Professional | 53 · Discontinued | $9.77 | $12.59 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $47.86 Typical High $125.89 | Professional | 54 · Surgery only | $36.31 | $47.86 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.55 Typical High $25.12 | Professional | 55 · Aftercare only | $7.24 | $9.55 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.31 Typical High $16.60 | Professional | 56 · Pre-op care only | $4.90 | $6.31 | $16.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $112.20 Typical High $239.88 | Professional | 51 · Multiple procedures | $112.20 | $112.20 | $239.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $44.67 Typical High $95.50 | Professional | 80 · Assistant surgeon | $44.67 | $44.67 | $95.50 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $31.62 Median $31.62 Typical High $67.61 | Professional | 81 · Minimal assistant surgeon | $31.62 | $31.62 | $67.61 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $31.62 Median $31.62 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $31.62 | $31.62 | $67.61 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $31.62 Typical High $67.61 | Professional | AS · PA/NP assist | $31.62 | $31.62 | $67.61 |
Where North Carolina sits
The same service costs 13.8 times more in Hawaii than in Louisiana. 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
HI $2,918LA $212
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.