How much rates vary
Facilitymedian $4,898 · 10th to 90th $871 to $11,220Professionalmedian $1,096 · 10th to 90th $617 to $1,778
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 $588.84 Median $588.84 Typical High $7,943.28 | Facility | None | $588.84 | $588.84 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $758.58 | Professional | None | $588.84 | $588.84 | $758.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,168.69 Median $6,165.95 Typical High $8,511.38 | Facility | None | $4,168.69 | $6,165.95 | $8,511.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $1,819.70 | Professional | None | $851.14 | $1,445.44 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,570.88 Typical High $7,585.78 | Facility | None | $602.56 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,584.89 | Professional | None | $724.44 | $870.96 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $8,912.51 | Facility | None | $602.56 | $4,265.80 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,258.93 | Professional | None | $602.56 | $812.83 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,584.89 | Professional | None | $602.56 | $891.25 | $1,584.89 |
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 $288.40 Median $288.40 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $288.40 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $549.54 | Professional | 54 · Surgery only | $436.52 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $512.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,230.27 Typical High $2,570.40 | Professional | 50 · Both sides | $891.25 | $1,230.27 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $407.38 Typical High $851.14 | Professional | 51 · Multiple procedures | $295.12 | $407.38 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $162.18 Typical High $338.84 | Professional | 80 · Assistant surgeon | $120.23 | $162.18 | $338.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $114.82 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $83.18 | $114.82 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $114.82 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $114.82 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $114.82 Typical High $239.88 | Professional | AS · PA/NP assist | $83.18 | $114.82 | $239.88 |
Where North Carolina sits
The same service costs 5.6 times more in Wisconsin than in Montana. 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
WI $10,313MT $1,845
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.