How much rates vary
Facilitymedian $3,548 · 10th to 90th $741 to $10,233Professionalmedian $1,445 · 10th to 90th $1,047 to $2,818
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 $1,047.13 Median $1,288.25 Typical High $8,317.64 | Facility | None | $1,047.13 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,570.40 Median $3,548.13 Typical High $11,220.18 | Facility | None | $2,570.40 | $3,548.13 | $11,220.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,659.59 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,011.87 Typical High $7,413.10 | Facility | None | $645.65 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,122.02 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,659.59 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $6,760.83 | Facility | None | $602.56 | $1,819.70 | $6,760.83 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,348.96 | $1,737.80 |
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 $851.14 Median $1,122.02 Typical High $2,570.40 | Professional | None | $851.14 | $1,122.02 | $2,570.40 |
14 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 $524.81 Median $524.81 Typical High $562.34 | Professional | 52 · Reduced service | $524.81 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $776.25 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $776.25 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $3,162.28 Typical High $10,964.78 | Facility | 50 · Both sides | $891.25 | $3,162.28 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,047.13 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $295.12 | $1,047.13 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,238.72 Typical High $3,801.89 | Professional | 50 · Both sides | $1,819.70 | $2,238.72 | $3,801.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $758.58 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $602.56 | $758.58 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $302.00 Typical High $501.19 | Professional | 80 · Assistant surgeon | $239.88 | $302.00 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $208.93 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $169.82 | $208.93 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $208.93 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $208.93 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $354.81 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $354.81 |
Where North Carolina sits
The same service costs 5.1 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 $14,362HI $2,794
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.