How much rates vary
Facilitymedian $1,995 · 10th to 90th $631 to $5,248Professionalmedian $646 · 10th to 90th $380 to $1,230
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 $380.19 Median $1,000.00 Typical High $8,317.64 | Facility | None | $380.19 | $1,000.00 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,412.54 | $2,089.30 | $2,818.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $380.19 Median $831.76 Typical High $1,288.25 | Professional | None | $380.19 | $831.76 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $3,388.44 | Facility | None | $645.65 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $1,047.13 | Professional | None | $512.86 | $562.34 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $2,511.89 | Facility | None | $575.44 | $977.24 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $676.08 | Professional | None | $457.09 | $562.34 | $676.08 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $954.99 | Professional | None | $389.05 | $562.34 | $954.99 |
13 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 $190.55 Median $190.55 Typical High $239.88 | Professional | 52 · Reduced service | $190.55 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $95.50 | Professional | 53 · Discontinued | $75.86 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $354.81 | Professional | 54 · Surgery only | $288.40 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $70.79 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $47.86 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,778.28 Typical High $5,495.41 | Facility | 50 · Both sides | $891.25 | $1,778.28 | $5,495.41 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $588.84 Typical High $1,819.70 | Facility | 51 · Multiple procedures | $295.12 | $588.84 | $1,819.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $977.24 Typical High $1,698.24 | Professional | 50 · Both sides | $776.25 | $977.24 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $323.59 Typical High $562.34 | Professional | 51 · Multiple procedures | $257.04 | $323.59 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $131.83 Typical High $223.87 | Professional | 80 · Assistant surgeon | $102.33 | $131.83 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $91.20 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $72.44 | $91.20 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $91.20 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $91.20 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $91.20 Typical High $158.49 | Professional | AS · PA/NP assist | $72.44 | $91.20 | $158.49 |
Where North Carolina sits
The same service costs 5.7 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 $6,741MT $1,191
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.