How much rates vary
Facilitymedian $219 · 10th to 90th $81 to $912Professionalmedian $417 · 10th to 90th $275 to $759
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 $257.04 Median $281.84 Typical High $7,413.10 | Facility | None | $257.04 | $281.84 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $436.52 | Professional | None | $257.04 | $281.84 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $323.59 | Facility | None | $81.28 | $128.82 | $323.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $776.25 | Professional | None | $309.03 | $467.74 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $218.78 Typical High $354.81 | Facility | None | $56.23 | $218.78 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $776.25 | Professional | None | $295.12 | $316.23 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $676.08 | Professional | None | $436.52 | $436.52 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $446.68 | Facility | None | $87.10 | $128.82 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $426.58 | Professional | None | $288.40 | $346.74 | $426.58 |
Oscar Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $223.87 Median $295.12 Typical High $645.65 | Professional | None | $223.87 | $295.12 | $645.65 |
12 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 $125.89 Median $141.25 Typical High $151.36 | Professional | 52 · Reduced service | $125.89 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $213.80 Typical High $223.87 | Professional | 54 · Surgery only | $190.55 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $38.02 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $177.83 | $199.53 | $208.93 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $40.74 Median $64.57 Typical High $223.87 | Facility | 51 · Multiple procedures | $40.74 | $64.57 | $223.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $173.78 Typical High $309.03 | Professional | 51 · Multiple procedures | $144.54 | $173.78 | $309.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $69.18 Typical High $125.89 | Professional | 80 · Assistant surgeon | $60.26 | $69.18 | $125.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $42.66 Median $48.98 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $42.66 | $48.98 | $87.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $42.66 Median $48.98 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $42.66 | $48.98 | $87.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $48.98 Typical High $87.10 | Professional | AS · PA/NP assist | $42.66 | $48.98 | $87.10 |
Where North Carolina sits
The same service costs 10.5 times more in Colorado than in Florida. 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 $4,157FL $396
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.