How much rates vary
Facilitymedian $3,467 · 10th to 90th $776 to $10,000Professionalmedian $1,148 · 10th to 90th $661 to $1,862
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 $645.65 Median $851.14 Typical High $8,511.38 | Facility | None | $645.65 | $851.14 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,230.27 | Professional | None | $645.65 | $645.65 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $1,174.90 | Professional | None | $588.84 | $1,023.29 | $1,174.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $4,365.16 | Facility | None | $2,187.76 | $3,235.94 | $4,365.16 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,949.84 | Professional | None | $891.25 | $1,174.90 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,466.84 Typical High $6,309.57 | Facility | None | $794.33 | $4,466.84 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,778.28 | Professional | None | $776.25 | $954.99 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,905.46 Typical High $4,466.84 | Facility | None | $724.44 | $1,905.46 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,659.59 | Professional | None | $741.31 | $1,047.13 | $1,659.59 |
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 $660.69 Median $954.99 Typical High $1,778.28 | Professional | None | $660.69 | $954.99 | $1,778.28 |
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 $323.59 Median $323.59 Typical High $407.38 | Professional | 52 · Reduced service | $323.59 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $165.96 | Professional | 53 · Discontinued | $128.82 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $575.44 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $954.99 Typical High $3,019.95 | Facility | 51 · Multiple procedures | $363.08 | $954.99 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $562.34 Typical High $954.99 | Professional | 51 · Multiple procedures | $436.52 | $562.34 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $223.87 Typical High $380.19 | Professional | 80 · Assistant surgeon | $173.78 | $223.87 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $158.49 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $123.03 | $158.49 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $158.49 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $158.49 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $158.49 Typical High $263.03 | Professional | AS · PA/NP assist | $123.03 | $158.49 | $263.03 |
Where North Carolina sits
The same service costs 5.3 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 $10,556MT $2,002
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.