How much rates vary
Facilitymedian $1,862 · 10th to 90th $457 to $5,248Professionalmedian $309 · 10th to 90th $219 to $617
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 $204.17 Median $1,000.00 Typical High $7,943.28 | Facility | None | $204.17 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $354.81 | Professional | None | $204.17 | $204.17 | $354.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,511.89 | Facility | None | $1,258.93 | $1,862.09 | $2,511.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $616.60 | Professional | None | $263.03 | $416.87 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,290.87 Typical High $3,388.44 | Facility | None | $457.09 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $549.54 | Professional | None | $245.47 | $295.12 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $2,511.89 | Facility | None | $371.54 | $776.25 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $389.05 | Professional | None | $245.47 | $288.40 | $389.05 |
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 $199.53 Median $257.04 Typical High $512.86 | Professional | None | $199.53 | $257.04 | $512.86 |
14 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 $102.33 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $186.21 | Professional | 54 · Surgery only | $151.36 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $141.25 | $141.25 | $173.78 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,548.82 Typical High $5,495.41 | Facility | 50 · Both sides | $562.34 | $1,548.82 | $5,495.41 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $524.81 Typical High $1,819.70 | Facility | 51 · Multiple procedures | $186.21 | $524.81 | $1,819.70 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $426.58 Typical High $891.25 | Professional | 50 · Both sides | $398.11 | $426.58 | $891.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $144.54 Typical High $302.00 | Professional | 51 · Multiple procedures | $134.90 | $144.54 | $302.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $57.54 Typical High $120.23 | Professional | 80 · Assistant surgeon | $53.70 | $57.54 | $120.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $39.81 Typical High $83.18 | Professional | 81 · Minimal assistant surgeon | $37.15 | $39.81 | $83.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $39.81 Typical High $83.18 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $39.81 | $83.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $39.81 Typical High $83.18 | Professional | AS · PA/NP assist | $37.15 | $39.81 | $83.18 |
Where North Carolina sits
The same service costs 9.6 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 $6,197MT $647
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.