How much rates vary
Facilitymedian $1,950 · 10th to 90th $813 to $9,772Professionalmedian $1,380 · 10th to 90th $891 to $2,344
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 $870.96 Median $1,288.25 Typical High $8,317.64 | Facility | None | $870.96 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,174.90 | Professional | None | $851.14 | $870.96 | $1,174.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $6,760.83 | Facility | None | $1,584.89 | $2,137.96 | $6,760.83 |
BCBS North Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,548.82 Typical High $2,454.71 | Professional | None | $933.25 | $1,548.82 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,513.56 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $3,388.44 | Facility | None | $602.56 | $1,258.93 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,412.54 | Professional | None | $912.01 | $1,000.00 | $1,412.54 |
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 $707.95 Median $977.24 Typical High $2,137.96 | Professional | None | $707.95 | $977.24 | $2,137.96 |
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 $426.58 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $173.78 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | 54 · Surgery only | $645.65 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $645.65 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $630.96 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $630.96 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $512.86 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $457.09 | $512.86 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $204.17 Typical High $407.38 | Professional | 80 · Assistant surgeon | $190.55 | $204.17 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $144.54 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $134.90 | $144.54 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $144.54 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $144.54 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $144.54 Typical High $288.40 | Professional | AS · PA/NP assist | $134.90 | $144.54 | $288.40 |
Where North Carolina sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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
WI $8,857KS $2,587
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.