How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,380 to $11,220Professionalmedian $1,738 · 10th to 90th $1,023 to $2,818
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 $912.01 Median $1,584.89 Typical High $11,481.54 | Facility | None | $912.01 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,548.82 | Professional | None | $912.01 | $912.01 | $1,548.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,238.72 Median $3,467.37 Typical High $8,912.51 | Facility | None | $2,238.72 | $3,467.37 | $8,912.51 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,949.84 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $5,128.61 Typical High $6,309.57 | Facility | None | $1,698.24 | $5,128.61 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,380.38 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $4,466.84 | Facility | None | $1,513.56 | $1,905.46 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $933.25 | $1,288.25 | $1,778.28 |
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 $933.25 Median $1,380.38 Typical High $2,511.89 | Professional | None | $933.25 | $1,380.38 | $2,511.89 |
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 $457.09 Median $457.09 Typical High $588.84 | Professional | 52 · Reduced service | $457.09 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | 53 · Discontinued | $181.97 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $870.96 | Professional | 54 · Surgery only | $691.83 | $691.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $812.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $776.25 Median $1,096.48 Typical High $3,019.95 | Facility | 51 · Multiple procedures | $776.25 | $1,096.48 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $645.65 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $467.74 | $645.65 | $1,348.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $257.04 Typical High $537.03 | Professional | 80 · Assistant surgeon | $186.21 | $257.04 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $181.97 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $131.83 | $181.97 | $380.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $181.97 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $181.97 | $380.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $181.97 Typical High $380.19 | Professional | AS · PA/NP assist | $131.83 | $181.97 | $380.19 |
Where North Carolina sits
The same service costs 4.0 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 $11,674MT $2,925
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.