How much rates vary
Facilitymedian $1,995 · 10th to 90th $759 to $6,457Professionalmedian $1,413 · 10th to 90th $832 to $2,399
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 $812.83 Median $1,148.15 Typical High $7,943.28 | Facility | None | $812.83 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $2,691.53 | Facility | None | $1,348.96 | $1,995.26 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,479.11 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,801.89 Typical High $5,623.41 | Facility | None | $602.56 | $3,801.89 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $2,238.72 | Professional | None | $891.25 | $1,096.48 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $4,073.80 | Facility | None | $524.81 | $1,122.02 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,348.96 | Professional | None | $812.83 | $1,047.13 | $1,348.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $2,041.74 | Professional | None | $794.33 | $1,023.29 | $2,041.74 |
14 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 $407.38 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $660.69 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,698.24 Typical High $8,317.64 | Facility | 50 · Both sides | $776.25 | $1,698.24 | $8,317.64 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $562.34 Typical High $2,818.38 | Facility | 51 · Multiple procedures | $257.04 | $562.34 | $2,818.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,548.82 Typical High $3,548.13 | Professional | 50 · Both sides | $1,380.38 | $1,548.82 | $3,548.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $524.81 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $457.09 | $524.81 | $1,202.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $208.93 Typical High $478.63 | Professional | 80 · Assistant surgeon | $181.97 | $208.93 | $478.63 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $144.54 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $128.82 | $144.54 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $144.54 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $144.54 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $144.54 Typical High $331.13 | Professional | AS · PA/NP assist | $128.82 | $144.54 | $331.13 |
Where North Carolina sits
The same service costs 5.1 times more in Colorado than in Delaware. 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 $11,463DE $2,264
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.