How much rates vary
Facilitymedian $2,455 · 10th to 90th $912 to $8,710Professionalmedian $1,905 · 10th to 90th $933 to $2,512
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 $912.01 Median $1,288.25 Typical High $10,471.29 | Facility | None | $912.01 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,047.13 | Professional | None | $912.01 | $912.01 | $1,047.13 |
BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $2,951.21 | Facility | None | $1,174.90 | $1,862.09 | $2,951.21 |
BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,174.90 | $2,041.74 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,011.87 Typical High $7,413.10 | Facility | None | $794.33 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,122.02 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,621.81 | $1,621.81 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,258.93 Typical High $6,760.83 | Facility | None | $741.31 | $1,258.93 | $6,760.83 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,479.11 | Professional | None | $870.96 | $1,071.52 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $2,238.72 | Professional | None | $741.31 | $1,047.13 | $2,238.72 |
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 $457.09 Median $457.09 Typical High $489.78 | Professional | 52 · Reduced service | $457.09 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | 53 · Discontinued | $181.97 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $676.08 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $691.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $630.96 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $363.08 | $630.96 | $3,715.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $524.81 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $436.52 | $524.81 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $426.58 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $147.91 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $125.89 | $147.91 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $147.91 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $147.91 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $302.00 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $302.00 |
Where North Carolina sits
The same service costs 4.2 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 $12,508MT $2,994
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.