How much rates vary
Facilitymedian $2,188 · 10th to 90th $631 to $7,079Professionalmedian $1,175 · 10th to 90th $661 to $1,820
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 $630.96 Median $1,288.25 Typical High $8,317.64 | Facility | None | $630.96 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | None | $630.96 | $630.96 | $741.31 |
BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,691.53 | $7,079.46 |
BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,862.09 | Professional | None | $794.33 | $1,174.90 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,584.89 | Professional | None | $741.31 | $758.58 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,122.02 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,230.27 Typical High $2,630.27 | Facility | None | $588.84 | $1,230.27 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,047.13 | Professional | None | $758.58 | $851.14 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,584.89 | Professional | None | $537.03 | $707.95 | $1,584.89 |
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 $316.23 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $501.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $2,137.96 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $2,137.96 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,348.96 Typical High $2,290.87 | Professional | 50 · Both sides | $1,174.90 | $1,348.96 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $446.68 Typical High $776.25 | Professional | 51 · Multiple procedures | $389.05 | $446.68 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $177.83 Typical High $309.03 | Professional | 80 · Assistant surgeon | $158.49 | $177.83 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $125.89 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $109.65 | $125.89 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $125.89 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $125.89 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $125.89 Typical High $213.80 | Professional | AS · PA/NP assist | $109.65 | $125.89 | $213.80 |
Where North Carolina sits
The same service costs 3.7 times more in Wisconsin 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
WI $7,647MT $2,070
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.