How much rates vary
Facilitymedian $2,630 · 10th to 90th $794 to $7,943Professionalmedian $1,096 · 10th to 90th $661 to $1,698
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 $1,000.00 Typical High $10,471.29 | Facility | None | $616.60 | $1,000.00 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,071.52 | Professional | None | $616.60 | $616.60 | $1,071.52 |
BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $3,548.13 | Facility | None | $1,737.80 | $2,630.27 | $3,548.13 |
BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,737.80 | Professional | None | $831.76 | $1,202.26 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,168.69 Typical High $6,025.60 | Facility | None | $794.33 | $4,168.69 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,659.59 | Professional | None | $707.95 | $891.25 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,479.11 Typical High $4,168.69 | Facility | None | $724.44 | $1,479.11 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,096.48 | Professional | None | $741.31 | $831.76 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,548.82 | Professional | None | $630.96 | $794.33 | $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 $309.03 Median $309.03 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $537.03 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $741.31 Typical High $2,818.38 | Facility | 51 · Multiple procedures | $363.08 | $741.31 | $2,818.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $416.87 Typical High $912.01 | Professional | 51 · Multiple procedures | $389.05 | $416.87 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $169.82 Typical High $363.08 | Professional | 80 · Assistant surgeon | $158.49 | $169.82 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $117.49 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $109.65 | $117.49 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $117.49 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $117.49 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $117.49 Typical High $257.04 | Professional | AS · PA/NP assist | $109.65 | $117.49 | $257.04 |
Where North Carolina sits
The same service costs 5.1 times more in Wisconsin 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
WI $10,170MT $2,000
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.