How much rates vary
Facilitymedian $3,981 · 10th to 90th $646 to $11,220Professionalmedian $891 · 10th to 90th $631 to $1,778
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 $616.60 Median $1,000.00 Typical High $8,317.64 | Facility | None | $616.60 | $1,000.00 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,122.02 | Professional | None | $616.60 | $616.60 | $1,122.02 |
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 $794.33 Median $1,047.13 Typical High $1,778.28 | Professional | None | $794.33 | $1,047.13 | $1,778.28 |
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 $724.44 Median $776.25 Typical High $1,513.56 | Professional | None | $724.44 | $776.25 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,148.15 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $6,918.31 | Facility | None | $602.56 | $2,290.87 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,258.93 | Professional | None | $741.31 | $851.14 | $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 $524.81 Median $724.44 Typical High $1,548.82 | Professional | None | $524.81 | $724.44 | $1,548.82 |
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 $309.03 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $489.78 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $3,467.37 Typical High $10,964.78 | Facility | 50 · Both sides | $891.25 | $3,467.37 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,148.15 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $295.12 | $1,148.15 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,412.54 Typical High $2,238.72 | Professional | 50 · Both sides | $1,122.02 | $1,412.54 | $2,238.72 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $467.74 Typical High $758.58 | Professional | 51 · Multiple procedures | $380.19 | $467.74 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $186.21 Typical High $302.00 | Professional | 80 · Assistant surgeon | $151.36 | $186.21 | $302.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $131.83 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $104.71 | $131.83 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $131.83 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $131.83 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $131.83 Typical High $208.93 | Professional | AS · PA/NP assist | $104.71 | $131.83 | $208.93 |
Where North Carolina sits
The same service costs 6.8 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 $13,753MT $2,023
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.