How much rates vary
Facilitymedian $1,660 · 10th to 90th $479 to $5,129Professionalmedian $562 · 10th to 90th $389 to $1,072
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 $363.08 Median $870.96 Typical High $7,943.28 | Facility | None | $363.08 | $870.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $645.65 | Professional | None | $363.08 | $363.08 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,290.87 | Facility | None | $891.25 | $1,412.54 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $398.11 Median $660.69 Typical High $1,096.48 | Professional | None | $398.11 | $660.69 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,187.76 Typical High $3,235.94 | Facility | None | $457.09 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $912.01 | Professional | None | $426.58 | $436.52 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $851.14 | Professional | None | $645.65 | $645.65 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $2,511.89 | Facility | None | $371.54 | $954.99 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $870.96 | Professional | None | $436.52 | $524.81 | $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 $309.03 Median $416.87 Typical High $912.01 | Professional | None | $309.03 | $416.87 | $912.01 |
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 $181.97 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $181.97 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | 54 · Surgery only | $269.15 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $295.12 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $478.63 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $186.21 | $478.63 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $263.03 Typical High $501.19 | Professional | 51 · Multiple procedures | $234.42 | $263.03 | $501.19 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $104.71 Typical High $199.53 | Professional | 80 · Assistant surgeon | $93.33 | $104.71 | $199.53 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $66.07 Median $74.13 Typical High $141.25 | Professional | 81 · Minimal assistant surgeon | $66.07 | $74.13 | $141.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $66.07 Median $74.13 Typical High $141.25 | Professional | 82 · Assistant surgeon, no resident | $66.07 | $74.13 | $141.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $74.13 Typical High $141.25 | Professional | AS · PA/NP assist | $66.07 | $74.13 | $141.25 |
Where North Carolina sits
The same service costs 5.3 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 $6,401MT $1,205
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.