How much rates vary
Facilitymedian $832 · 10th to 90th $380 to $7,244Professionalmedian $562 · 10th to 90th $389 to $1,122
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 $380.19 Median $380.19 Typical High $7,943.28 | Facility | None | $380.19 | $380.19 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $660.69 | Professional | None | $380.19 | $380.19 | $660.69 |
BCBS North Carolina Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,148.15 | Professional | None | $436.52 | $691.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $1,047.13 | Professional | None | $389.05 | $537.03 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $1,380.38 | Facility | None | $380.19 | $457.09 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $831.76 | Professional | None | $363.08 | $501.19 | $831.76 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $1,047.13 | Professional | None | $380.19 | $549.54 | $1,047.13 |
11 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 $190.55 Median $190.55 Typical High $251.19 | Professional | 52 · Reduced service | $190.55 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $100.00 | Professional | 53 · Discontinued | $75.86 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $371.54 | Professional | 54 · Surgery only | $288.40 | $288.40 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $75.86 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $346.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $251.19 Typical High $549.54 | Professional | 51 · Multiple procedures | $181.97 | $251.19 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $100.00 Typical High $218.78 | Professional | 80 · Assistant surgeon | $72.44 | $100.00 | $218.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $69.18 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $51.29 | $69.18 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $69.18 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $69.18 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $69.18 Typical High $154.88 | Professional | AS · PA/NP assist | $51.29 | $69.18 | $154.88 |
Where North Carolina sits
The same service costs 6.7 times more in Colorado than in Arkansas. 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 $6,451AR $969
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.