How much rates vary
Facilitymedian $1,778 · 10th to 90th $537 to $5,370Professionalmedian $661 · 10th to 90th $398 to $1,479
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 $346.74 Median $537.03 Typical High $7,585.78 | Facility | None | $346.74 | $537.03 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $645.65 | Professional | None | $346.74 | $537.03 | $645.65 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,786.30 | Facility | None | $1,202.26 | $1,862.09 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $398.11 Median $758.58 Typical High $1,548.82 | Professional | None | $398.11 | $758.58 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,235.94 | Facility | None | $602.56 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $1,174.90 | Professional | None | $380.19 | $588.84 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,318.26 | Professional | None | $831.76 | $831.76 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $954.99 Typical High $3,388.44 | Facility | None | $512.86 | $954.99 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $870.96 | Professional | None | $501.19 | $660.69 | $870.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $1,174.90 | Professional | None | $346.74 | $575.44 | $1,174.90 |
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 $173.78 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $173.78 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $69.18 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $257.04 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $51.29 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $34.67 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $346.74 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $239.88 | $346.74 | $380.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,445.44 Typical High $5,011.87 | Facility | 50 · Both sides | $776.25 | $1,445.44 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $489.78 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $263.03 | $489.78 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,000.00 Typical High $1,819.70 | Professional | 50 · Both sides | $758.58 | $1,000.00 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $331.13 Typical High $616.60 | Professional | 51 · Multiple procedures | $251.19 | $331.13 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $131.83 Typical High $245.47 | Professional | 80 · Assistant surgeon | $100.00 | $131.83 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $93.33 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $70.79 | $93.33 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $93.33 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $93.33 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $93.33 Typical High $169.82 | Professional | AS · PA/NP assist | $70.79 | $93.33 | $169.82 |
Where North Carolina sits
The same service costs 4.4 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 $6,451MT $1,460
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.