How much rates vary
Facilitymedian $263 · 10th to 90th $100 to $1,230Professionalmedian $676 · 10th to 90th $457 to $1,318
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 $446.68 Median $478.63 Typical High $7,413.10 | Facility | None | $446.68 | $478.63 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $537.03 | Professional | None | $446.68 | $478.63 | $537.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $323.59 | Facility | None | $81.28 | $128.82 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,348.96 | Professional | None | $562.34 | $794.33 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $1,318.26 | Facility | None | $162.18 | $263.03 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $1,071.52 | Professional | None | $457.09 | $501.19 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,122.02 | Professional | None | $741.31 | $741.31 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $380.19 Typical High $707.95 | Facility | None | $87.10 | $380.19 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $794.33 | Professional | None | $457.09 | $549.54 | $794.33 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $1,122.02 | Professional | None | $380.19 | $501.19 | $1,122.02 |
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 $223.87 Median $239.88 Typical High $251.19 | Professional | 52 · Reduced service | $223.87 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $89.13 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $331.13 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $66.07 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $50.12 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $354.81 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $123.03 Median $467.74 Typical High $758.58 | Facility | 50 · Both sides | $123.03 | $467.74 | $758.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $154.88 Typical High $251.19 | Facility | 51 · Multiple procedures | $40.74 | $154.88 | $251.19 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $831.76 Typical High $1,778.28 | Professional | 50 · Both sides | $691.83 | $831.76 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $275.42 Typical High $588.84 | Professional | 51 · Multiple procedures | $229.09 | $275.42 | $588.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $234.42 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $234.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $64.57 Median $77.62 Typical High $165.96 | Professional | 81 · Minimal assistant surgeon | $64.57 | $77.62 | $165.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $64.57 Median $77.62 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $64.57 | $77.62 | $165.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $77.62 Typical High $165.96 | Professional | AS · PA/NP assist | $64.57 | $77.62 | $165.96 |
Where North Carolina sits
The same service costs 4.9 times more in Connecticut than in Florida. 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
CT $3,107FL $640
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.