How much rates vary
Facilitymedian $891 · 10th to 90th $380 to $7,244Professionalmedian $1,288 · 10th to 90th $933 to $2,344
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 $891.25 Median $891.25 Typical High $7,943.28 | Facility | None | $891.25 | $891.25 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | None | $891.25 | $891.25 | $1,096.48 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,698.24 | $2,454.71 |
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 $977.24 Median $1,230.27 Typical High $2,398.83 | Professional | None | $977.24 | $1,230.27 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $3,981.07 | Facility | None | $891.25 | $1,071.52 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,174.90 | $1,737.80 |
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 $891.25 Median $1,122.02 Typical High $2,187.76 | Professional | None | $891.25 | $1,122.02 | $2,187.76 |
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 $446.68 Median $446.68 Typical High $549.54 | Professional | 52 · Reduced service | $446.68 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $218.78 | Professional | 53 · Discontinued | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $588.84 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $575.44 | $588.84 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $239.88 Typical High $512.86 | Professional | 80 · Assistant surgeon | $229.09 | $239.88 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $165.96 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $162.18 | $165.96 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $165.96 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $165.96 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $165.96 Typical High $363.08 | Professional | AS · PA/NP assist | $162.18 | $165.96 | $363.08 |
Where North Carolina sits
The same service costs 6.9 times more in Colorado than in Maryland. 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 $11,121MD $1,609
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.