How much rates vary
Facilitymedian $5,129 · 10th to 90th $832 to $11,220Professionalmedian $1,514 · 10th to 90th $776 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 $724.44 Median $1,288.25 Typical High $10,471.29 | Facility | None | $724.44 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,288.25 | Professional | None | $724.44 | $724.44 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,548.13 Median $5,754.40 Typical High $9,120.11 | Facility | None | $3,548.13 | $5,754.40 | $9,120.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $2,089.30 | Professional | None | $891.25 | $1,513.56 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $7,079.46 Typical High $10,232.93 | Facility | None | $794.33 | $7,079.46 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,778.28 | Professional | None | $851.14 | $870.96 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,288.25 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $7,413.10 | Facility | None | $724.44 | $3,090.30 | $7,413.10 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,230.27 | Professional | None | $851.14 | $1,023.29 | $1,230.27 |
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 $616.60 Median $812.83 Typical High $1,778.28 | Professional | None | $616.60 | $812.83 | $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 $144.54 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $575.44 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $5,370.32 Typical High $10,964.78 | Facility | 50 · Both sides | $1,096.48 | $5,370.32 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,819.70 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $363.08 | $1,819.70 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,513.56 Typical High $2,630.27 | Professional | 50 · Both sides | $1,348.96 | $1,513.56 | $2,630.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $512.86 Typical High $870.96 | Professional | 51 · Multiple procedures | $446.68 | $512.86 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $204.17 Typical High $346.74 | Professional | 80 · Assistant surgeon | $181.97 | $204.17 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $141.25 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $125.89 | $141.25 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $141.25 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $141.25 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $141.25 Typical High $245.47 | Professional | AS · PA/NP assist | $125.89 | $141.25 | $245.47 |
Where North Carolina sits
The same service costs 6.2 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 $14,513MT $2,350
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.