How much rates vary
Facilitymedian $3,715 · 10th to 90th $617 to $10,715Professionalmedian $1,122 · 10th to 90th $427 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 $354.81 Median $1,122.02 Typical High $7,943.28 | Facility | None | $354.81 | $1,122.02 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,122.02 Typical High $1,348.96 | Professional | None | $354.81 | $1,122.02 | $1,348.96 |
BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $6,606.93 | Facility | None | $1,659.59 | $2,570.40 | $6,606.93 |
BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,122.02 Typical High $3,467.37 | Professional | None | $630.96 | $1,122.02 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,365.16 Typical High $6,309.57 | Facility | None | $645.65 | $4,365.16 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $1,348.96 Typical High $2,238.72 | Professional | None | $426.58 | $1,348.96 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $1,288.25 Typical High $6,025.60 | Facility | None | $575.44 | $1,288.25 | $6,025.60 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,479.11 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,378.01 | Facility | None | $1,380.38 | $4,265.80 | $17,378.01 |
United Setting Professional Modifier None Typical Low $389.05 Median $1,148.15 Typical High $2,570.40 | Professional | None | $389.05 | $1,148.15 | $2,570.40 |
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 $177.83 Median $302.00 Typical High $575.44 | Professional | 52 · Reduced service | $177.83 | $302.00 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $120.23 Typical High $229.09 | Professional | 53 · Discontinued | $70.79 | $120.23 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $457.09 Typical High $851.14 | Professional | 54 · Surgery only | $269.15 | $457.09 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $91.20 Typical High $169.82 | Professional | 55 · Aftercare only | $53.70 | $91.20 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $60.26 Typical High $114.82 | Professional | 56 · Pre-op care only | $35.48 | $60.26 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $426.58 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $251.19 | $426.58 | $794.33 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $691.83 Typical High $3,019.95 | Facility | 51 · Multiple procedures | $295.12 | $691.83 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $741.31 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $524.81 | $741.31 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $295.12 Typical High $645.65 | Professional | 80 · Assistant surgeon | $208.93 | $295.12 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $208.93 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $147.91 | $208.93 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $208.93 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $208.93 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $208.93 Typical High $457.09 | Professional | AS · PA/NP assist | $147.91 | $208.93 | $457.09 |
Where North Carolina sits
The same service costs 4.0 times more in Wisconsin than in North Dakota. 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 $9,724ND $2,433
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.