How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,512 · 10th to 90th $1,445 to $3,802
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 $1,288.25 Median $1,348.96 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,348.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,348.96 | $1,737.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $4,168.69 | Professional | None | $1,862.09 | $2,511.89 | $4,168.69 |
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 $1,445.44 Median $1,995.26 Typical High $3,715.35 | Professional | None | $1,445.44 | $1,995.26 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $6,025.60 | Facility | None | $1,348.96 | $1,621.81 | $6,025.60 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,698.24 | $2,454.71 |
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 $1,380.38 Median $1,949.84 Typical High $3,715.35 | Professional | None | $1,380.38 | $1,949.84 | $3,715.35 |
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 $676.08 Median $676.08 Typical High $870.96 | Professional | 52 · Reduced service | $676.08 | $676.08 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $346.74 | Professional | 53 · Discontinued | $269.15 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,202.26 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $112.20 | $112.20 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $912.01 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $676.08 | $912.01 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $371.54 Typical High $794.33 | Professional | 80 · Assistant surgeon | $269.15 | $371.54 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $186.21 Median $257.04 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $186.21 | $257.04 | $549.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $186.21 Median $257.04 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $186.21 | $257.04 | $549.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $257.04 Typical High $549.54 | Professional | AS · PA/NP assist | $186.21 | $257.04 | $549.54 |
Where North Carolina sits
The same service costs 8.9 times more in Alabama 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
AL $18,845MD $2,111
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.