How much rates vary
Facilitymedian $851 · 10th to 90th $380 to $7,244Professionalmedian $1,445 · 10th to 90th $851 to $2,089
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 $794.33 Median $794.33 Typical High $7,943.28 | Facility | None | $794.33 | $794.33 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $977.24 | Professional | None | $794.33 | $794.33 | $977.24 |
BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,548.82 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $2,137.96 | Professional | None | $933.25 | $1,122.02 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $3,801.89 | Facility | None | $794.33 | $954.99 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,380.38 | Professional | None | $954.99 | $1,174.90 | $1,380.38 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,949.84 | Professional | None | $776.25 | $1,023.29 | $1,949.84 |
11 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 $398.11 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $194.98 | Professional | 53 · Discontinued | $158.49 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $97.72 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $588.84 Typical High $1,148.15 | Professional | 51 · Multiple procedures | $537.03 | $588.84 | $1,148.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $234.42 Typical High $457.09 | Professional | 80 · Assistant surgeon | $213.80 | $234.42 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $162.18 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $151.36 | $162.18 | $323.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $162.18 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $162.18 | $323.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $162.18 Typical High $323.59 | Professional | AS · PA/NP assist | $151.36 | $162.18 | $323.59 |
Where North Carolina sits
The same service costs 6.2 times more in Alaska than in Texas. 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.
North Carolina· 12th of 51
$1,445
AK $3,311TX $537
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.