How much rates vary
Facilitymedian $3,311 · 10th to 90th $617 to $10,000Professionalmedian $759 · 10th to 90th $490 to $1,413
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 $371.54 Median $501.19 Typical High $8,511.38 | Facility | None | $371.54 | $501.19 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $630.96 | Professional | None | $371.54 | $501.19 | $630.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $9,772.37 | Facility | None | $2,454.71 | $3,801.89 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $1,621.81 | Professional | None | $588.84 | $954.99 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,073.80 Typical High $6,025.60 | Facility | None | $794.33 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $1,288.25 | Professional | None | $489.78 | $602.56 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $4,265.80 | Facility | None | $602.56 | $1,202.26 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $870.96 | Professional | None | $537.03 | $691.83 | $870.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $1,230.27 | Professional | None | $426.58 | $602.56 | $1,230.27 |
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 $186.21 Median $251.19 Typical High $309.03 | Professional | 52 · Reduced service | $186.21 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $75.86 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $380.19 Typical High $467.74 | Professional | 54 · Surgery only | $281.84 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $75.86 Typical High $93.33 | Professional | 55 · Aftercare only | $56.23 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $50.12 Typical High $61.66 | Professional | 56 · Pre-op care only | $37.15 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $354.81 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $263.03 | $354.81 | $436.52 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $363.08 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $346.74 Typical High $776.25 | Professional | 51 · Multiple procedures | $269.15 | $346.74 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $138.04 Typical High $309.03 | Professional | 80 · Assistant surgeon | $107.15 | $138.04 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $75.86 Median $97.72 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $75.86 | $97.72 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $75.86 Median $97.72 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $75.86 | $97.72 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $97.72 Typical High $213.80 | Professional | AS · PA/NP assist | $75.86 | $97.72 | $213.80 |
Where North Carolina sits
The same service costs 6.1 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 $9,157MT $1,508
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.