How much rates vary
Facilitymedian $1,778 · 10th to 90th $603 to $5,248Professionalmedian $269 · 10th to 90th $170 to $479
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 $158.49 Median $1,148.15 Typical High $7,943.28 | Facility | None | $158.49 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $295.12 | Professional | None | $158.49 | $158.49 | $295.12 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,122.02 | $1,698.24 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $489.78 | Professional | None | $204.17 | $331.13 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $3,388.44 | Facility | None | $602.56 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $426.58 | Professional | None | $190.55 | $223.87 | $426.58 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $2,344.23 | Facility | None | $446.68 | $977.24 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $316.23 | Professional | None | $186.21 | $208.93 | $316.23 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $389.05 | Professional | None | $158.49 | $208.93 | $389.05 |
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 $77.62 Median $77.62 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $31.62 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 54 · Surgery only | $117.49 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $28.18 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $19.05 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 51 · Multiple procedures | $100.00 | $100.00 | $100.00 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $616.60 Typical High $1,584.89 | Facility | 51 · Multiple procedures | $257.04 | $616.60 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $104.71 Typical High $229.09 | Professional | 51 · Multiple procedures | $102.33 | $104.71 | $229.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $41.69 Typical High $91.20 | Professional | 80 · Assistant surgeon | $41.69 | $41.69 | $91.20 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.84 Median $29.51 Typical High $63.10 | Professional | 81 · Minimal assistant surgeon | $28.84 | $29.51 | $63.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.84 Median $29.51 Typical High $63.10 | Professional | 82 · Assistant surgeon, no resident | $28.84 | $29.51 | $63.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $29.51 Typical High $63.10 | Professional | AS · PA/NP assist | $28.84 | $29.51 | $63.10 |
Where North Carolina sits
The same service costs 13.0 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 $6,260MT $480
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.