How much rates vary
Facilitymedian $1,950 · 10th to 90th $776 to $5,248Professionalmedian $1,072 · 10th to 90th $575 to $1,660
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 $549.54 Median $1,288.25 Typical High $10,471.29 | Facility | None | $549.54 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $724.44 | Professional | None | $549.54 | $549.54 | $724.44 |
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 $758.58 Median $1,096.48 Typical High $1,659.59 | Professional | None | $758.58 | $1,096.48 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,388.44 | Facility | None | $794.33 | $2,511.89 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,479.11 | Professional | None | $602.56 | $776.25 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,047.13 Typical High $2,511.89 | Facility | None | $707.95 | $1,047.13 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $977.24 | Professional | None | $630.96 | $776.25 | $977.24 |
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 $524.81 Median $676.08 Typical High $1,380.38 | Professional | None | $524.81 | $676.08 | $1,380.38 |
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 $275.42 Median $275.42 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | 54 · Surgery only | $416.87 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $467.74 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $1,819.70 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $380.19 Typical High $812.83 | Professional | 51 · Multiple procedures | $316.23 | $380.19 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $154.88 Typical High $323.59 | Professional | 80 · Assistant surgeon | $125.89 | $154.88 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $107.15 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $89.13 | $107.15 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $107.15 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $107.15 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $107.15 Typical High $229.09 | Professional | AS · PA/NP assist | $89.13 | $107.15 | $229.09 |
Where North Carolina sits
The same service costs 4.1 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 $7,274MT $1,783
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.