How much rates vary
Facilitymedian $339 · 10th to 90th $120 to $1,096Professionalmedian $380 · 10th to 90th $224 to $692
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 $173.78 Median $257.04 Typical High $7,413.10 | Facility | None | $173.78 | $257.04 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $281.84 | Professional | None | $173.78 | $251.19 | $281.84 |
BCBS Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $331.13 | Facility | None | $165.96 | $245.47 | $331.13 |
BCBS Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $707.95 | Professional | None | $251.19 | $407.38 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $512.86 Typical High $1,318.26 | Facility | None | $346.74 | $512.86 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $436.52 | Professional | None | $194.98 | $251.19 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $630.96 | Professional | None | $354.81 | $354.81 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $151.36 Median $380.19 Typical High $676.08 | Facility | None | $151.36 | $380.19 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $323.59 | Professional | None | $245.47 | $251.19 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | None | $229.09 | $229.09 | $239.88 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $398.11 | Professional | None | $169.82 | $239.88 | $398.11 |
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 $87.10 Median $120.23 Typical High $131.83 | Professional | 52 · Reduced service | $87.10 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $47.86 Typical High $52.48 | Professional | 53 · Discontinued | $34.67 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $131.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $36.31 Typical High $39.81 | Professional | 55 · Aftercare only | $26.30 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.99 Typical High $26.30 | Professional | 56 · Pre-op care only | $17.38 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $165.96 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $165.96 | $181.97 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $70.79 Median $194.98 Typical High $338.84 | Facility | 51 · Multiple procedures | $70.79 | $194.98 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $128.82 Typical High $173.78 | Professional | 51 · Multiple procedures | $123.03 | $128.82 | $173.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $50.12 Typical High $66.07 | Professional | 80 · Assistant surgeon | $48.98 | $50.12 | $66.07 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $34.67 Median $35.48 Typical High $45.71 | Professional | 81 · Minimal assistant surgeon | $34.67 | $35.48 | $45.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $34.67 Median $35.48 Typical High $45.71 | Professional | 82 · Assistant surgeon, no resident | $34.67 | $35.48 | $45.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $35.48 Typical High $45.71 | Professional | AS · PA/NP assist | $34.67 | $35.48 | $45.71 |
Where North Carolina sits
The same service costs 4.2 times more in Alaska than in Texas. 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.
North Carolina· 9th of 51
$380
AK $741TX $178
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.