How much rates vary
Facilitymedian $3,388 · 10th to 90th $708 to $10,000Professionalmedian $1,349 · 10th to 90th $851 to $2,344
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 $776.25 Median $1,148.15 Typical High $7,943.28 | Facility | None | $776.25 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $954.99 | Professional | None | $776.25 | $776.25 | $954.99 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $9,772.37 | Facility | None | $2,454.71 | $3,801.89 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,548.82 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $6,025.60 | Facility | None | $602.56 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,584.89 | Professional | None | $851.14 | $891.25 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,230.27 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $4,265.80 | Facility | None | $524.81 | $1,380.38 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,023.29 | Professional | None | $758.58 | $933.25 | $1,023.29 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $870.96 | Professional | None | $831.76 | $831.76 | $870.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,548.82 | Professional | None | $691.83 | $870.96 | $1,548.82 |
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 $389.05 Median $389.05 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $660.69 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $257.04 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $467.74 Typical High $602.56 | Professional | 51 · Multiple procedures | $380.19 | $467.74 | $602.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $186.21 Typical High $245.47 | Professional | 80 · Assistant surgeon | $151.36 | $186.21 | $245.47 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $131.83 Typical High $169.82 | Professional | 81 · Minimal assistant surgeon | $104.71 | $131.83 | $169.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $131.83 Typical High $169.82 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $131.83 | $169.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $131.83 Typical High $169.82 | Professional | AS · PA/NP assist | $104.71 | $131.83 | $169.82 |
Where North Carolina sits
The same service costs 4.2 times more in Colorado than in Hawaii. 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 $9,583HI $2,259
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.