How much rates vary
Facilitymedian $3,388 · 10th to 90th $794 to $9,550Professionalmedian $1,230 · 10th to 90th $759 to $2,089
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 $724.44 Median $1,023.29 Typical High $10,471.29 | Facility | None | $724.44 | $1,023.29 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,258.93 | Professional | None | $724.44 | $724.44 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,230.27 | Professional | None | $933.25 | $933.25 | $1,230.27 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $4,897.79 | Facility | None | $1,905.46 | $3,090.30 | $4,897.79 |
BCBS North Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,137.96 | Professional | None | $933.25 | $1,258.93 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,011.87 Typical High $7,413.10 | Facility | None | $794.33 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,819.70 | Professional | None | $812.83 | $851.14 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,230.27 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $5,248.07 | Facility | None | $741.31 | $2,137.96 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,380.38 | Professional | None | $891.25 | $1,000.00 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,819.70 | Professional | None | $630.96 | $812.83 | $1,819.70 |
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 $363.08 Median $363.08 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $549.54 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $588.84 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $3,162.28 Typical High $10,964.78 | Facility | 50 · Both sides | $1,096.48 | $3,162.28 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,047.13 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $363.08 | $1,047.13 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,584.89 Typical High $2,691.53 | Professional | 50 · Both sides | $1,380.38 | $1,584.89 | $2,691.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $524.81 Typical High $891.25 | Professional | 51 · Multiple procedures | $457.09 | $524.81 | $891.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $208.93 Typical High $354.81 | Professional | 80 · Assistant surgeon | $186.21 | $208.93 | $354.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $147.91 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $128.82 | $147.91 | $251.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $147.91 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $147.91 | $251.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $147.91 Typical High $251.19 | Professional | AS · PA/NP assist | $128.82 | $147.91 | $251.19 |
Where North Carolina sits
The same service costs 5.7 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 $13,613MT $2,377
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.