How much rates vary
Facilitymedian $3,802 · 10th to 90th $661 to $10,965Professionalmedian $1,380 · 10th to 90th $724 to $1,950
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 $660.69 Median $1,047.13 Typical High $8,317.64 | Facility | None | $660.69 | $1,047.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,000.00 | Professional | None | $660.69 | $660.69 | $1,000.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,570.40 Median $3,981.07 Typical High $10,232.93 | Facility | None | $2,570.40 | $3,981.07 | $10,232.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $1,949.84 | Professional | None | $891.25 | $1,380.38 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,309.57 Typical High $9,549.93 | Facility | None | $645.65 | $6,309.57 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,659.59 | Professional | None | $812.83 | $1,023.29 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,479.11 | $1,479.11 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $7,413.10 | Facility | None | $588.84 | $1,659.59 | $7,413.10 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,230.27 | Professional | None | $794.33 | $912.01 | $1,230.27 |
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 $562.34 Median $831.76 Typical High $1,659.59 | Professional | None | $562.34 | $831.76 | $1,659.59 |
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 $331.13 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $524.81 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $3,162.28 Typical High $11,220.18 | Facility | 50 · Both sides | $891.25 | $3,162.28 | $11,220.18 |
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 $1,288.25 Median $1,479.11 Typical High $2,511.89 | Professional | 50 · Both sides | $1,288.25 | $1,479.11 | $2,511.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $489.78 Typical High $851.14 | Professional | 51 · Multiple procedures | $426.58 | $489.78 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $194.98 Typical High $338.84 | Professional | 80 · Assistant surgeon | $173.78 | $194.98 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $138.04 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $123.03 | $138.04 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $138.04 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $138.04 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $138.04 Typical High $234.42 | Professional | AS · PA/NP assist | $123.03 | $138.04 | $234.42 |
Where North Carolina sits
The same service costs 6.4 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 $13,837MT $2,168
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.