How much rates vary
Facilitymedian $1,047 · 10th to 90th $501 to $3,388Professionalmedian $813 · 10th to 90th $537 to $1,445
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 $478.63 Median $575.44 Typical High $7,244.36 | Facility | None | $478.63 | $575.44 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $812.83 | Professional | None | $478.63 | $537.03 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,584.89 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $1,445.44 | Professional | None | $588.84 | $933.25 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $1,819.70 | Facility | None | $602.56 | $1,445.44 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $1,230.27 | Professional | None | $537.03 | $588.84 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,258.93 | Professional | None | $870.96 | $870.96 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,905.46 | Facility | None | $512.86 | $933.25 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $977.24 | Professional | None | $645.65 | $707.95 | $977.24 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $1,202.26 | Professional | None | $436.52 | $575.44 | $1,202.26 |
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 $239.88 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $97.72 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $47.86 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $398.11 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,445.44 Typical High $2,818.38 | Facility | 50 · Both sides | $776.25 | $1,445.44 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $489.78 Typical High $933.25 | Facility | 51 · Multiple procedures | $257.04 | $489.78 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,071.52 Typical High $1,995.26 | Professional | 50 · Both sides | $977.24 | $1,071.52 | $1,995.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $354.81 Typical High $660.69 | Professional | 51 · Multiple procedures | $331.13 | $354.81 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $141.25 Typical High $263.03 | Professional | 80 · Assistant surgeon | $131.83 | $141.25 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $91.20 Median $100.00 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $91.20 | $100.00 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $91.20 Median $100.00 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $91.20 | $100.00 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $100.00 Typical High $186.21 | Professional | AS · PA/NP assist | $91.20 | $100.00 | $186.21 |
Where North Carolina sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.