How much rates vary
Facilitymedian $6,761 · 10th to 90th $955 to $12,882Professionalmedian $1,778 · 10th to 90th $977 to $2,692
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 $891.25 Median $1,230.27 Typical High $11,481.54 | Facility | None | $891.25 | $1,230.27 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,584.89 | Professional | None | $891.25 | $891.25 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6,760.83 Median $10,000.00 Typical High $13,489.63 | Facility | None | $6,760.83 | $10,000.00 | $13,489.63 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,862.09 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $7,413.10 Typical High $12,302.69 | Facility | None | $891.25 | $7,413.10 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,258.93 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $4,168.69 Typical High $8,709.64 | Facility | None | $933.25 | $4,168.69 | $8,709.64 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,258.93 | $1,479.11 |
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 $891.25 Median $1,148.15 Typical High $2,238.72 | Professional | None | $891.25 | $1,148.15 | $2,238.72 |
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 $446.68 Median $446.68 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $223.87 | Professional | 53 · Discontinued | $177.83 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $165.96 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $776.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,905.46 Typical High $3,981.07 | Professional | 50 · Both sides | $1,659.59 | $1,905.46 | $3,981.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $630.96 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $549.54 | $630.96 | $1,318.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $251.19 Typical High $524.81 | Professional | 80 · Assistant surgeon | $218.78 | $251.19 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $177.83 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $154.88 | $177.83 | $371.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $177.83 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $177.83 | $371.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $177.83 Typical High $371.54 | Professional | AS · PA/NP assist | $154.88 | $177.83 | $371.54 |
Where North Carolina sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.