How much rates vary
Facilitymedian $4,266 · 10th to 90th $661 to $12,023Professionalmedian $1,072 · 10th to 90th $692 to $1,905
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 $891.25 Typical High $7,943.28 | Facility | None | $660.69 | $891.25 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,148.15 | Professional | None | $660.69 | $660.69 | $1,148.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,691.53 Median $3,715.35 Typical High $11,748.98 | Facility | None | $2,691.53 | $3,715.35 | $11,748.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,905.46 | Professional | None | $851.14 | $1,122.02 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,309.57 Typical High $9,332.54 | Facility | None | $645.65 | $6,309.57 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,621.81 | Professional | None | $758.58 | $776.25 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,174.90 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $7,079.46 | Facility | None | $602.56 | $2,290.87 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,258.93 | Professional | None | $794.33 | $891.25 | $1,258.93 |
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 $562.34 Median $741.31 Typical High $1,659.59 | Professional | None | $562.34 | $741.31 | $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 $489.78 Median $489.78 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $112.20 |
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 $457.09 Median $457.09 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $524.81 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $3,467.37 Typical High $14,454.40 | Facility | 50 · Both sides | $891.25 | $3,467.37 | $14,454.40 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,148.15 Typical High $4,897.79 | Facility | 51 · Multiple procedures | $295.12 | $1,148.15 | $4,897.79 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,513.56 Typical High $2,398.83 | Professional | 50 · Both sides | $1,202.26 | $1,513.56 | $2,398.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $501.19 Typical High $812.83 | Professional | 51 · Multiple procedures | $407.38 | $501.19 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $199.53 Typical High $323.59 | Professional | 80 · Assistant surgeon | $162.18 | $199.53 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $141.25 Typical High $223.87 | Professional | 81 · Minimal assistant surgeon | $112.20 | $141.25 | $223.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $141.25 Typical High $223.87 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $141.25 | $223.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $141.25 Typical High $223.87 | Professional | AS · PA/NP assist | $112.20 | $141.25 | $223.87 |
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 $13,816MT $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.