How much rates vary
Facilitymedian $3,890 · 10th to 90th $776 to $10,471Professionalmedian $1,023 · 10th to 90th $661 to $1,862
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 $645.65 Median $891.25 Typical High $8,511.38 | Facility | None | $645.65 | $891.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,096.48 | Professional | None | $645.65 | $645.65 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $5,128.61 | Facility | None | $1,995.26 | $3,235.94 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,862.09 | Professional | None | $831.76 | $1,096.48 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,011.87 Typical High $7,413.10 | Facility | None | $794.33 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,584.89 | Professional | None | $707.95 | $741.31 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,071.52 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $2,290.87 Typical High $5,248.07 | Facility | None | $724.44 | $2,290.87 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,174.90 | Professional | None | $776.25 | $870.96 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,621.81 | Professional | None | $549.54 | $707.95 | $1,621.81 |
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 $323.59 Median $323.59 Typical High $363.08 | Professional | 52 · Reduced service | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $109.65 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $512.86 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $3,467.37 Typical High $10,964.78 | Facility | 50 · Both sides | $1,096.48 | $3,467.37 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,148.15 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $363.08 | $1,148.15 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,380.38 Typical High $2,344.23 | Professional | 50 · Both sides | $1,174.90 | $1,380.38 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $457.09 Typical High $794.33 | Professional | 51 · Multiple procedures | $389.05 | $457.09 | $794.33 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $181.97 Typical High $316.23 | Professional | 80 · Assistant surgeon | $158.49 | $181.97 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $128.82 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $109.65 | $128.82 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $128.82 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $128.82 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $128.82 Typical High $218.78 | Professional | AS · PA/NP assist | $109.65 | $128.82 | $218.78 |
Where North Carolina sits
The same service costs 6.5 times more in Colorado than in Montana. 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 $13,795MT $2,119
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.