How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $3,020 · 10th to 90th $1,995 to $5,623
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 $1,862.09 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,862.09 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,862.09 | $1,862.09 | $2,454.71 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,691.53 Median $3,715.35 Typical High $5,754.40 | Professional | None | $2,691.53 | $3,715.35 | $5,754.40 |
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 $2,344.23 Median $2,818.38 Typical High $5,623.41 | Professional | None | $2,344.23 | $2,818.38 | $5,623.41 |
Medcost Setting Facility Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $3,019.95 | Facility | None | $1,862.09 | $1,949.84 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,630.27 Typical High $3,019.95 | Professional | None | $1,778.28 | $2,630.27 | $3,019.95 |
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 $1,905.46 Median $2,951.21 Typical High $5,128.61 | Professional | None | $1,905.46 | $2,951.21 | $5,128.61 |
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 $933.25 Median $933.25 Typical High $1,202.26 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $478.63 | Professional | 53 · Discontinued | $371.54 | $371.54 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $239.88 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $1,318.26 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $891.25 | $1,318.26 | $2,754.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $524.81 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $354.81 | $524.81 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $371.54 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $245.47 | $371.54 | $758.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $371.54 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $371.54 | $758.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $371.54 Typical High $758.58 | Professional | AS · PA/NP assist | $245.47 | $371.54 | $758.58 |
Where North Carolina sits
The same service costs 8.0 times more in Alabama than in Washington. 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 $20,353WA $2,540
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.