How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,000 to $12,882Professionalmedian $1,905 · 10th to 90th $1,072 to $3,020
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 $1,047.13 Median $1,288.25 Typical High $10,715.19 | Facility | None | $1,047.13 | $1,288.25 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,047.13 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $1,479.11 Typical High $1,862.09 | Professional | None | $234.42 | $1,479.11 | $1,862.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,090.30 Median $4,265.80 Typical High $13,489.63 | Facility | None | $3,090.30 | $4,265.80 | $13,489.63 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,905.46 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $5,128.61 Typical High $11,748.98 | Facility | None | $912.01 | $5,128.61 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,258.93 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,905.46 | $1,905.46 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $5,248.07 | Facility | None | $831.76 | $1,995.26 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,548.82 | $1,778.28 |
Oscar Health Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $15,848.93 | Facility | None | $6,309.57 | $6,309.57 | $15,848.93 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $2,570.40 | Professional | None | $891.25 | $1,174.90 | $2,570.40 |
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 $524.81 Median $524.81 Typical High $588.84 | Professional | 52 · Reduced service | $524.81 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $239.88 | Professional | 53 · Discontinued | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $891.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $831.76 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,230.27 Median $3,548.13 Typical High $10,964.78 | Facility | 50 · Both sides | $1,230.27 | $3,548.13 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,202.26 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $416.87 | $1,202.26 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,630.27 Typical High $3,801.89 | Professional | 50 · Both sides | $1,995.26 | $2,630.27 | $3,801.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $891.25 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $660.69 | $891.25 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $354.81 Typical High $501.19 | Professional | 80 · Assistant surgeon | $269.15 | $354.81 | $501.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $245.47 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $186.21 | $245.47 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $245.47 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $245.47 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $245.47 Typical High $354.81 | Professional | AS · PA/NP assist | $186.21 | $245.47 | $354.81 |
Where North Carolina sits
The same service costs 4.2 times more in Colorado 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
CO $14,362MT $3,396
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.