How much rates vary
Facilitymedian $6,026 · 10th to 90th $871 to $15,488Professionalmedian $1,175 · 10th to 90th $479 to $13,804
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 $363.08 Median $5,888.44 Typical High $10,964.78 | Facility | None | $363.08 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $1,584.89 Typical High $7,943.28 | Professional | None | $363.08 | $1,584.89 | $7,943.28 |
BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $5,888.44 Typical High $9,120.11 | Facility | None | $3,548.13 | $5,888.44 | $9,120.11 |
BCBS Setting Professional Modifier None Typical Low $616.60 Median $1,412.54 Typical High $14,791.08 | Professional | None | $616.60 | $1,412.54 | $14,791.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,128.61 Typical High $8,511.38 | Facility | None | $602.56 | $5,128.61 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $12,022.64 | Professional | None | $489.78 | $794.33 | $12,022.64 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $5,888.44 Typical High $10,964.78 | Facility | None | $371.54 | $5,888.44 | $10,964.78 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $6,456.54 Typical High $9,120.11 | Professional | None | $537.03 | $6,456.54 | $9,120.11 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,232.93 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,232.93 | $26,302.68 |
United Setting Professional Modifier None Typical Low $407.38 Median $891.25 Typical High $13,489.63 | Professional | None | $407.38 | $891.25 | $13,489.63 |
10 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 $181.97 Median $309.03 Typical High $2,951.21 | Professional | 52 · Reduced service | $181.97 | $309.03 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $123.03 Typical High $1,174.90 | Professional | 53 · Discontinued | $72.44 | $123.03 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $457.09 Typical High $4,466.84 | Professional | 54 · Surgery only | $275.42 | $457.09 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $91.20 Typical High $891.25 | Professional | 55 · Aftercare only | $54.95 | $91.20 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $61.66 Typical High $588.84 | Professional | 56 · Pre-op care only | $36.31 | $61.66 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $3,162.28 Typical High $8,317.64 | Professional | 51 · Multiple procedures | $269.15 | $3,162.28 | $8,317.64 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $1,288.25 Typical High $3,311.31 | Professional | 80 · Assistant surgeon | $109.65 | $1,288.25 | $3,311.31 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $75.86 Median $891.25 Typical High $2,290.87 | Professional | 81 · Minimal assistant surgeon | $75.86 | $891.25 | $2,290.87 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $75.86 Median $891.25 Typical High $2,290.87 | Professional | 82 · Assistant surgeon, no resident | $75.86 | $891.25 | $2,290.87 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $891.25 Typical High $2,290.87 | Professional | AS · PA/NP assist | $75.86 | $891.25 | $2,290.87 |
Where North Carolina sits
The same service costs 6.6 times more in Wisconsin than in Kentucky. 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 $17,634KY $2,675
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.