How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,023 to $10,000Professionalmedian $1,514 · 10th to 90th $912 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 $891.25 Median $1,202.26 Typical High $13,803.84 | Facility | None | $891.25 | $1,202.26 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,479.11 | Professional | None | $891.25 | $891.25 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,819.70 | Professional | None | $776.25 | $1,258.93 | $1,819.70 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $8,511.38 | Facility | None | $2,137.96 | $3,311.31 | $8,511.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,659.59 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $5,011.87 Typical High $6,025.60 | Facility | None | $1,698.24 | $5,011.87 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,174.90 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $4,168.69 | Facility | None | $1,513.56 | $1,778.28 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,148.15 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,187.76 | Professional | None | $870.96 | $1,230.27 | $2,187.76 |
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 $446.68 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $691.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $776.25 Median $954.99 Typical High $2,818.38 | Facility | 51 · Multiple procedures | $776.25 | $954.99 | $2,818.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $575.44 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $549.54 | $575.44 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $229.09 Typical High $512.86 | Professional | 80 · Assistant surgeon | $218.78 | $229.09 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $158.49 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $154.88 | $158.49 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $158.49 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $158.49 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $158.49 Typical High $363.08 | Professional | AS · PA/NP assist | $154.88 | $158.49 | $363.08 |
Where North Carolina sits
The same service costs 4.2 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 $11,551MT $2,762
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.