How much rates vary
Facilitymedian $2,138 · 10th to 90th $550 to $6,918Professionalmedian $871 · 10th to 90th $240 to $1,905
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 $177.83 Median $794.33 Typical High $7,244.36 | Facility | None | $177.83 | $794.33 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $724.44 Typical High $1,071.52 | Professional | None | $177.83 | $724.44 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $281.84 | Professional | None | $138.04 | $194.98 | $281.84 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $5,495.41 | Facility | None | $1,380.38 | $2,137.96 | $5,495.41 |
BCBS North Carolina Setting Professional Modifier None Typical Low $323.59 Median $954.99 Typical High $2,041.74 | Professional | None | $323.59 | $954.99 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,818.38 Typical High $4,073.80 | Facility | None | $602.56 | $2,818.38 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $616.60 Typical High $1,584.89 | Professional | None | $239.88 | $616.60 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $3,162.28 | Facility | None | $446.68 | $977.24 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,380.38 | Professional | None | $724.44 | $954.99 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $204.17 Median $724.44 Typical High $1,737.80 | Professional | None | $204.17 | $724.44 | $1,737.80 |
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 $89.13 Median $147.91 Typical High $398.11 | Professional | 52 · Reduced service | $89.13 | $147.91 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $58.88 Typical High $158.49 | Professional | 53 · Discontinued | $35.48 | $58.88 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $223.87 Typical High $602.56 | Professional | 54 · Surgery only | $134.90 | $223.87 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $44.67 Typical High $120.23 | Professional | 55 · Aftercare only | $26.92 | $44.67 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $29.51 Typical High $79.43 | Professional | 56 · Pre-op care only | $17.78 | $29.51 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $208.93 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $125.89 | $208.93 | $562.34 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $537.03 Typical High $2,344.23 | Facility | 51 · Multiple procedures | $257.04 | $537.03 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $478.63 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $363.08 | $478.63 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $190.55 Typical High $446.68 | Professional | 80 · Assistant surgeon | $144.54 | $190.55 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $131.83 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $102.33 | $131.83 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $131.83 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $131.83 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $131.83 Typical High $309.03 | Professional | AS · PA/NP assist | $102.33 | $131.83 | $309.03 |
Where North Carolina sits
The same service costs 5.1 times more in Colorado 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
CO $7,315MT $1,443
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.