How much rates vary
Facilitymedian $4,169 · 10th to 90th $646 to $10,965Professionalmedian $759 · 10th to 90th $562 to $1,585
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 $537.03 Median $1,584.89 Typical High $10,964.78 | Facility | None | $537.03 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | None | $537.03 | $537.03 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,290.87 Median $3,715.35 Typical High $5,888.44 | Facility | None | $2,290.87 | $3,715.35 | $5,888.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,584.89 | Professional | None | $691.83 | $933.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,011.87 Typical High $7,413.10 | Facility | None | $645.65 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $1,318.26 | Professional | None | $602.56 | $616.60 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,258.93 | Professional | None | $912.01 | $912.01 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $2,398.83 Typical High $5,248.07 | Facility | None | $588.84 | $2,398.83 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,202.26 | Professional | None | $645.65 | $660.69 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,318.26 | Professional | None | $457.09 | $588.84 | $1,318.26 |
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 $269.15 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $426.58 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $3,548.13 Typical High $10,964.78 | Facility | 50 · Both sides | $891.25 | $3,548.13 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $1,202.26 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $295.12 | $1,202.26 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,000.00 Typical High $2,290.87 | Professional | 50 · Both sides | $1,000.00 | $1,000.00 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $331.13 Typical High $758.58 | Professional | 51 · Multiple procedures | $331.13 | $331.13 | $758.58 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $131.83 Typical High $309.03 | Professional | 80 · Assistant surgeon | $131.83 | $131.83 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $93.33 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $93.33 | $93.33 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $93.33 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $93.33 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $93.33 Typical High $213.80 | Professional | AS · PA/NP assist | $93.33 | $93.33 | $213.80 |
Where North Carolina sits
The same service costs 7.9 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 $13,941MT $1,762
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.