How much rates vary
Facilitymedian $3,162 · 10th to 90th $832 to $10,000Professionalmedian $1,230 · 10th to 90th $661 to $2,089
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 $707.95 Median $831.76 Typical High $10,471.29 | Facility | None | $707.95 | $831.76 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,288.25 | Professional | None | $707.95 | $707.95 | $1,288.25 |
BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,715.35 | $5,128.61 |
BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,380.38 Typical High $2,089.30 | Professional | None | $660.69 | $1,380.38 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,513.56 | $1,513.56 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,778.28 Typical High $3,388.44 | Facility | None | $724.44 | $1,778.28 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,318.26 | Professional | None | $851.14 | $977.24 | $1,318.26 |
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 $602.56 Median $870.96 Typical High $1,737.80 | Professional | None | $602.56 | $870.96 | $1,737.80 |
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 $346.74 Median $346.74 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 53 · Discontinued | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $562.34 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $954.99 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $954.99 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $512.86 Typical High $891.25 | Professional | 51 · Multiple procedures | $457.09 | $512.86 | $891.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $204.17 Typical High $354.81 | Professional | 80 · Assistant surgeon | $181.97 | $204.17 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $144.54 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $128.82 | $144.54 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $144.54 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $144.54 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $144.54 Typical High $251.19 | Professional | AS · PA/NP assist | $128.82 | $144.54 | $251.19 |
Where North Carolina sits
The same service costs 4.4 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 $9,724MT $2,195
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.