How much rates vary
Facilitymedian $1,175 · 10th to 90th $389 to $7,079Professionalmedian $2,291 · 10th to 90th $1,318 to $3,311
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 $1,174.90 Median $1,174.90 Typical High $7,943.28 | Facility | None | $1,174.90 | $1,174.90 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,174.90 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,454.71 | $3,311.31 |
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 $1,479.11 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,698.24 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $2,238.72 | Facility | None | $1,258.93 | $2,238.72 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,621.81 | $1,905.46 |
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 $1,202.26 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,698.24 | $2,884.03 |
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 $588.84 Median $588.84 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $794.33 Median $812.83 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $794.33 | $812.83 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $323.59 Typical High $691.83 | Professional | 80 · Assistant surgeon | $316.23 | $323.59 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $223.87 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $223.87 | $223.87 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $223.87 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $223.87 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $223.87 Typical High $478.63 | Professional | AS · PA/NP assist | $223.87 | $223.87 | $478.63 |
Where North Carolina sits
The same service costs 6.3 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 $11,778MD $1,881
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.