How much rates vary
Facilitymedian $347 · 10th to 90th $110 to $1,738Professionalmedian $589 · 10th to 90th $380 to $1,047
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 $346.74 Median $380.19 Typical High $7,585.78 | Facility | None | $346.74 | $380.19 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $660.69 | Professional | None | $346.74 | $380.19 | $660.69 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,621.81 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,122.02 | Professional | None | $457.09 | $707.95 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $1,737.80 | Facility | None | $162.18 | $263.03 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $977.24 | Professional | None | $407.38 | $426.58 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $912.01 | Professional | None | $630.96 | $630.96 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $181.97 Median $524.81 Typical High $933.25 | Facility | None | $181.97 | $524.81 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $707.95 | Professional | None | $426.58 | $501.19 | $707.95 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $1,000.00 | Professional | None | $309.03 | $416.87 | $1,000.00 |
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 $173.78 Median $190.55 Typical High $218.78 | Professional | 52 · Reduced service | $173.78 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $331.13 | Professional | 54 · Surgery only | $257.04 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $66.07 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $34.67 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $269.15 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $239.88 | $269.15 | $309.03 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $257.04 Median $776.25 Typical High $1,412.54 | Facility | 50 · Both sides | $257.04 | $776.25 | $1,412.54 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $85.11 Median $257.04 Typical High $467.74 | Facility | 51 · Multiple procedures | $85.11 | $257.04 | $467.74 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $758.58 Typical High $1,584.89 | Professional | 50 · Both sides | $660.69 | $758.58 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $251.19 Typical High $524.81 | Professional | 51 · Multiple procedures | $218.78 | $251.19 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $100.00 Typical High $208.93 | Professional | 80 · Assistant surgeon | $87.10 | $100.00 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $61.66 Median $70.79 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $61.66 | $70.79 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $61.66 Median $70.79 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $61.66 | $70.79 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $70.79 Typical High $147.91 | Professional | AS · PA/NP assist | $61.66 | $70.79 | $147.91 |
Where North Carolina sits
The same service costs 5.3 times more in New York than in Delaware. 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
NY $3,063DE $576
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.