How much rates vary
Facilitymedian $4,074 · 10th to 90th $708 to $11,220Professionalmedian $1,230 · 10th to 90th $724 to $1,995
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 $7,943.28 | Facility | None | $707.95 | $831.76 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,230.27 | Professional | None | $707.95 | $707.95 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $912.01 Median $1,258.93 Typical High $2,041.74 | Professional | None | $912.01 | $1,258.93 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,011.87 Typical High $7,413.10 | Facility | None | $645.65 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,778.28 | Professional | None | $758.58 | $776.25 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,122.02 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $5,248.07 | Facility | None | $602.56 | $2,290.87 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,202.26 | Professional | None | $831.76 | $912.01 | $1,202.26 |
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 $602.56 Median $776.25 Typical High $1,778.28 | Professional | None | $602.56 | $776.25 | $1,778.28 |
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 $354.81 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $354.81 | $354.81 | $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 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 $1,230.27 Median $1,380.38 Typical High $2,570.40 | Professional | 50 · Both sides | $1,230.27 | $1,380.38 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $457.09 Typical High $870.96 | Professional | 51 · Multiple procedures | $416.87 | $457.09 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $181.97 Typical High $346.74 | Professional | 80 · Assistant surgeon | $169.82 | $181.97 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $128.82 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $117.49 | $128.82 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $128.82 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $128.82 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $128.82 Typical High $239.88 | Professional | AS · PA/NP assist | $117.49 | $128.82 | $239.88 |
Where North Carolina sits
The same service costs 6.0 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 $13,882MT $2,296
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.