How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,023 to $10,000Professionalmedian $1,738 · 10th to 90th $1,288 to $3,548
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 $1,258.93 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,258.93 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,258.93 | $2,089.30 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,801.89 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $3,715.35 | Professional | None | $1,548.82 | $2,238.72 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $5,011.87 Typical High $7,413.10 | Facility | None | $912.01 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,445.44 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,089.30 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $6,918.31 | Facility | None | $831.76 | $2,137.96 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,584.89 | $2,089.30 |
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 $1,071.52 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,412.54 | $3,090.30 |
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 $630.96 Median $630.96 Typical High $724.44 | Professional | 52 · Reduced service | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,000.00 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,047.13 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $416.87 | $1,047.13 | $3,715.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $794.33 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $724.44 | $794.33 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $316.23 Typical High $602.56 | Professional | 80 · Assistant surgeon | $288.40 | $316.23 | $602.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $218.78 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $199.53 | $218.78 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $218.78 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $218.78 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $218.78 Typical High $426.58 | Professional | AS · PA/NP assist | $199.53 | $218.78 | $426.58 |
Where North Carolina sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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
CO $14,661HI $3,664
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.