How much rates vary
Facilitymedian $417 · 10th to 90th $93 to $1,698Professionalmedian $617 · 10th to 90th $417 to $1,202
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 $416.87 Median $457.09 Typical High $7,413.10 | Facility | None | $416.87 | $457.09 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $660.69 | Professional | None | $416.87 | $457.09 | $660.69 |
BCBS North Carolina Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $162.18 | Facility | None | $79.43 | $117.49 | $162.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,202.26 | Professional | None | $467.74 | $741.31 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,318.26 Typical High $1,737.80 | Facility | None | $457.09 | $1,318.26 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $1,047.13 | Professional | None | $380.19 | $467.74 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,096.48 | Professional | None | $676.08 | $676.08 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $489.78 Typical High $1,621.81 | Facility | None | $87.10 | $489.78 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $776.25 | Professional | None | $446.68 | $512.86 | $776.25 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $1,047.13 | Professional | None | $363.08 | $457.09 | $1,047.13 |
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 $208.93 Median $229.09 Typical High $239.88 | Professional | 52 · Reduced service | $208.93 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $309.03 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $47.86 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $288.40 | $323.59 | $338.84 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $676.08 Typical High $2,818.38 | Facility | 50 · Both sides | $123.03 | $676.08 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $223.87 Typical High $933.25 | Facility | 51 · Multiple procedures | $40.74 | $223.87 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $776.25 Typical High $1,698.24 | Professional | 50 · Both sides | $660.69 | $776.25 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $223.87 Median $257.04 Typical High $575.44 | Professional | 51 · Multiple procedures | $223.87 | $257.04 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $102.33 Typical High $229.09 | Professional | 80 · Assistant surgeon | $89.13 | $102.33 | $229.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $72.44 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $61.66 | $72.44 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $72.44 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $72.44 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $72.44 Typical High $158.49 | Professional | AS · PA/NP assist | $61.66 | $72.44 | $158.49 |
Where North Carolina sits
The same service costs 5.3 times more in Colorado than in Florida. 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 $4,377FL $831
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.