How much rates vary
Facilitymedian $5,623 · 10th to 90th $741 to $11,220Professionalmedian $1,175 · 10th to 90th $776 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 $741.31 Median $1,202.26 Typical High $8,317.64 | Facility | None | $741.31 | $1,202.26 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,288.25 | Professional | None | $741.31 | $741.31 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,786.30 Median $7,079.46 Typical High $9,549.93 | Facility | None | $4,786.30 | $7,079.46 | $9,549.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $2,187.76 | Professional | None | $891.25 | $1,318.26 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,456.54 Typical High $9,549.93 | Facility | None | $645.65 | $6,456.54 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,862.09 | Professional | None | $831.76 | $870.96 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $7,244.36 | Facility | None | $602.56 | $1,380.38 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,202.26 | Professional | None | $891.25 | $1,023.29 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,819.70 | Professional | None | $630.96 | $831.76 | $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 $371.54 Median $371.54 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $588.84 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $5,370.32 Typical High $15,135.61 | Facility | 50 · Both sides | $891.25 | $5,370.32 | $15,135.61 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,819.70 Typical High $5,011.87 | Facility | 51 · Multiple procedures | $295.12 | $1,819.70 | $5,011.87 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,621.81 Typical High $2,630.27 | Professional | 50 · Both sides | $1,380.38 | $1,621.81 | $2,630.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $537.03 Typical High $870.96 | Professional | 51 · Multiple procedures | $467.74 | $537.03 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $346.74 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $151.36 Typical High $245.47 | Professional | 81 · Minimal assistant surgeon | $128.82 | $151.36 | $245.47 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $151.36 Typical High $245.47 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $151.36 | $245.47 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $245.47 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $245.47 |
Where North Carolina sits
The same service costs 6.0 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 $14,230MT $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.