How much rates vary
Facilitymedian $1,549 · 10th to 90th $447 to $5,129Professionalmedian $794 · 10th to 90th $447 to $1,288
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 $416.87 Median $446.68 Typical High $7,413.10 | Facility | None | $416.87 | $446.68 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $549.54 | Professional | None | $416.87 | $446.68 | $549.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $4,466.84 | Facility | None | $1,122.02 | $1,737.80 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,318.26 | Professional | None | $588.84 | $912.01 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,659.59 Typical High $2,454.71 | Facility | None | $457.09 | $1,659.59 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $1,148.15 | Professional | None | $436.52 | $575.44 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $2,187.76 | Facility | None | $380.19 | $776.25 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $741.31 | Professional | None | $501.19 | $616.60 | $741.31 |
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 $407.38 Median $524.81 Typical High $1,122.02 | Professional | None | $407.38 | $524.81 | $1,122.02 |
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 $208.93 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $309.03 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $288.40 | $309.03 | $371.54 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $407.38 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $186.21 | $407.38 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $363.08 Typical High $645.65 | Professional | 51 · Multiple procedures | $302.00 | $363.08 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $144.54 Typical High $257.04 | Professional | 80 · Assistant surgeon | $120.23 | $144.54 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $100.00 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $85.11 | $100.00 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $100.00 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $100.00 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $181.97 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $181.97 |
Where North Carolina sits
The same service costs 4.8 times more in Colorado than in North Dakota. 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 $6,549ND $1,369
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.