How much rates vary
Facilitymedian $3,802 · 10th to 90th $851 to $11,220Professionalmedian $1,479 · 10th to 90th $871 to $2,344
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 $851.14 Median $1,023.29 Typical High $6,760.83 | Facility | None | $851.14 | $1,023.29 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,445.44 | Professional | None | $851.14 | $851.14 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $1,445.44 | Professional | None | $194.98 | $239.88 | $1,445.44 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $5,128.61 | Facility | None | $1,995.26 | $3,235.94 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,479.11 | $2,454.71 |
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 $1,000.00 Median $1,023.29 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,023.29 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,479.11 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $2,290.87 Typical High $7,079.46 | Facility | None | $588.84 | $2,290.87 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,174.90 | $1,584.89 |
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 $724.44 Median $977.24 Typical High $2,137.96 | Professional | None | $724.44 | $977.24 | $2,137.96 |
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 $426.58 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $645.65 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $676.08 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $3,467.37 Typical High $14,454.40 | Facility | 50 · Both sides | $891.25 | $3,467.37 | $14,454.40 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,148.15 Typical High $4,897.79 | Facility | 51 · Multiple procedures | $295.12 | $1,148.15 | $4,897.79 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,041.74 Typical High $3,090.30 | Professional | 50 · Both sides | $1,548.82 | $2,041.74 | $3,090.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $676.08 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $512.86 | $676.08 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $269.15 Typical High $416.87 | Professional | 80 · Assistant surgeon | $208.93 | $269.15 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $144.54 | $190.55 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $190.55 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | AS · PA/NP assist | $144.54 | $190.55 | $288.40 |
Where North Carolina sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.