How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,096 to $12,303Professionalmedian $1,318 · 10th to 90th $891 to $2,291
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 $812.83 Median $1,096.48 Typical High $12,589.25 | Facility | None | $812.83 | $1,096.48 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,288.25 | Professional | None | $812.83 | $812.83 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,801.89 Median $5,623.41 Typical High $7,585.78 | Facility | None | $3,801.89 | $5,623.41 | $7,585.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,737.80 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $7,413.10 Typical High $12,302.69 | Facility | None | $1,584.89 | $7,413.10 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,148.15 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $3,162.28 Median $4,897.79 Typical High $9,120.11 | Facility | None | $3,162.28 | $4,897.79 | $9,120.11 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,348.96 | Professional | None | $977.24 | $1,230.27 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,466.84 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,466.84 | $17,782.79 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,187.76 | Professional | None | $831.76 | $1,230.27 | $2,187.76 |
8 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 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $645.65 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,584.89 Median $2,454.71 Typical High $4,570.88 | Facility | 51 · Multiple procedures | $1,584.89 | $2,454.71 | $4,570.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $660.69 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $549.54 | $660.69 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $467.74 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $186.21 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $154.88 | $186.21 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $186.21 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $186.21 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $331.13 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $331.13 |
Where North Carolina sits
The same service costs 6.1 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 $15,685MT $2,577
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.