How much rates vary
Facilitymedian $2,239 · 10th to 90th $646 to $6,310Professionalmedian $1,288 · 10th to 90th $646 to $7,762
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 $588.84 Median $1,288.25 Typical High $10,964.78 | Facility | None | $588.84 | $1,288.25 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $758.58 | Professional | None | $588.84 | $588.84 | $758.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $3,162.28 | Facility | None | $1,584.89 | $2,344.23 | $3,162.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,513.56 Typical High $7,762.47 | Professional | None | $776.25 | $1,513.56 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,548.82 | Professional | None | $724.44 | $724.44 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,096.48 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,202.26 Typical High $2,570.40 | Facility | None | $588.84 | $1,202.26 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,318.26 | Professional | None | $707.95 | $812.83 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,445.44 | Professional | None | $524.81 | $707.95 | $1,445.44 |
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 $295.12 Median $295.12 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $446.68 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $478.63 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,949.84 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $1,949.84 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $645.65 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $645.65 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,202.26 Typical High $2,137.96 | Professional | 50 · Both sides | $1,174.90 | $1,202.26 | $2,137.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $407.38 Typical High $707.95 | Professional | 51 · Multiple procedures | $398.11 | $407.38 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $162.18 Typical High $281.84 | Professional | 80 · Assistant surgeon | $158.49 | $162.18 | $281.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $112.20 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $112.20 | $112.20 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $112.20 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $112.20 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $112.20 Typical High $199.53 | Professional | AS · PA/NP assist | $112.20 | $112.20 | $199.53 |
Where North Carolina sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.