How much rates vary
Facilitymedian $2,399 · 10th to 90th $832 to $5,888Professionalmedian $1,549 · 10th to 90th $794 to $2,188
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 $794.33 Median $1,096.48 Typical High $10,471.29 | Facility | None | $794.33 | $1,096.48 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $3,467.37 | Facility | None | $1,737.80 | $2,570.40 | $3,467.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,905.46 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $3,235.94 | Facility | None | $794.33 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,995.26 | Professional | None | $831.76 | $891.25 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,258.93 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $2,818.38 | Facility | None | $741.31 | $1,412.54 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,318.26 | Professional | None | $851.14 | $977.24 | $1,318.26 |
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 $676.08 Median $870.96 Typical High $1,949.84 | Professional | None | $676.08 | $870.96 | $1,949.84 |
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 $398.11 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $398.11 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $158.49 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $588.84 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $630.96 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $2,137.96 Typical High $5,011.87 | Facility | 50 · Both sides | $1,096.48 | $2,137.96 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,479.11 Typical High $2,884.03 | Professional | 50 · Both sides | $1,288.25 | $1,479.11 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $489.78 Typical High $954.99 | Professional | 51 · Multiple procedures | $426.58 | $489.78 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $194.98 Typical High $389.05 | Professional | 80 · Assistant surgeon | $173.78 | $194.98 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $138.04 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $123.03 | $138.04 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $138.04 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $138.04 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $138.04 Typical High $269.15 | Professional | AS · PA/NP assist | $123.03 | $138.04 | $269.15 |
Where North Carolina sits
The same service costs 3.1 times more in Wisconsin 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
WI $8,115MD $2,591
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.