How much rates vary
Facilitymedian $4,365 · 10th to 90th $724 to $10,000Professionalmedian $1,047 · 10th to 90th $661 to $1,820
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 $616.60 Median $1,584.89 Typical High $11,481.54 | Facility | None | $616.60 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | None | $616.60 | $616.60 | $758.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $8,317.64 | Facility | None | $3,981.07 | $5,888.44 | $8,317.64 |
BCBS North Carolina Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,862.09 | Professional | None | $724.44 | $1,202.26 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,365.16 Typical High $7,244.36 | Facility | None | $741.31 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,258.93 | Professional | None | $660.69 | $660.69 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,479.11 | Professional | None | $977.24 | $977.24 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $6,165.95 | Facility | None | $724.44 | $724.44 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $954.99 | Professional | None | $602.56 | $741.31 | $954.99 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | None | $676.08 | $676.08 | $691.83 |
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 $537.03 Median $660.69 Typical High $1,202.26 | Professional | None | $537.03 | $660.69 | $1,202.26 |
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 $309.03 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $309.03 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $524.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $380.19 Typical High $489.78 | Professional | 51 · Multiple procedures | $302.00 | $380.19 | $489.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $154.88 Typical High $204.17 | Professional | 80 · Assistant surgeon | $120.23 | $154.88 | $204.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $107.15 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $83.18 | $107.15 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $107.15 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $107.15 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $107.15 Typical High $144.54 | Professional | AS · PA/NP assist | $83.18 | $107.15 | $144.54 |
Where North Carolina sits
The same service costs 5.4 times more in Colorado than in Montana. 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 $11,084MT $2,070
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.