How much rates vary
Facilitymedian $1,230 · 10th to 90th $525 to $2,818Professionalmedian $562 · 10th to 90th $363 to $1,148
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 $398.11 Median $1,288.25 Typical High $8,317.64 | Facility | None | $398.11 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $724.44 | Professional | None | $398.11 | $398.11 | $724.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Facility | None | $912.01 | $1,348.96 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $1,148.15 | Professional | None | $363.08 | $691.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $2,089.30 | Facility | None | $645.65 | $1,445.44 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $1,000.00 | Professional | None | $436.52 | $457.09 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $954.99 | Professional | None | $645.65 | $645.65 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $1,778.28 | Facility | None | $575.44 | $794.33 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $676.08 | Professional | None | $416.87 | $489.78 | $676.08 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $1,000.00 | Professional | None | $338.84 | $436.52 | $1,000.00 |
12 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 $199.53 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $316.23 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $426.58 Typical High $933.25 | Facility | 51 · Multiple procedures | $295.12 | $426.58 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $239.88 Typical High $489.78 | Professional | 51 · Multiple procedures | $204.17 | $239.88 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $194.98 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $194.98 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $67.61 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $57.54 | $67.61 | $138.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $67.61 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $67.61 | $138.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $67.61 Typical High $138.04 | Professional | AS · PA/NP assist | $57.54 | $67.61 | $138.04 |
Where North Carolina sits
The same service costs 4.0 times more in Colorado than in Maryland. 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 $4,941MD $1,230
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.