How much rates vary
Facilitymedian $3,802 · 10th to 90th $708 to $10,965Professionalmedian $933 · 10th to 90th $692 to $1,905
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 $676.08 Median $1,445.44 Typical High $10,715.19 | Facility | None | $676.08 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,122.02 | Professional | None | $676.08 | $676.08 | $1,122.02 |
BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $6,606.93 Typical High $16,982.44 | Facility | None | $4,265.80 | $6,606.93 | $16,982.44 |
BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,949.84 | Professional | None | $776.25 | $1,148.15 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,365.16 Typical High $7,244.36 | Facility | None | $602.56 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,698.24 | Professional | None | $724.44 | $758.58 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,071.52 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,584.89 Typical High $6,309.57 | Facility | None | $812.83 | $1,584.89 | $6,309.57 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,122.02 | Professional | None | $776.25 | $831.76 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,698.24 | Professional | None | $549.54 | $724.44 | $1,698.24 |
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 $338.84 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,258.93 Typical High $2,454.71 | Professional | 50 · Both sides | $1,230.27 | $1,258.93 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $416.87 Typical High $812.83 | Professional | 51 · Multiple procedures | $416.87 | $416.87 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $165.96 Typical High $331.13 | Professional | 80 · Assistant surgeon | $165.96 | $165.96 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $117.49 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $114.82 | $117.49 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $117.49 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $117.49 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $117.49 Typical High $229.09 | Professional | AS · PA/NP assist | $114.82 | $117.49 | $229.09 |
Where North Carolina sits
The same service costs 5.3 times more in Oklahoma than in Kentucky. 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
OK $10,109KY $1,891
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.