How much rates vary
Facilitymedian $4,169 · 10th to 90th $977 to $12,303Professionalmedian $1,585 · 10th to 90th $1,000 to $2,512
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 $977.24 Median $1,318.26 Typical High $13,803.84 | Facility | None | $977.24 | $1,318.26 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $2,089.30 | Professional | None | $954.99 | $977.24 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $1,995.26 | Professional | None | $851.14 | $1,445.44 | $1,995.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,819.70 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $7,413.10 Typical High $12,302.69 | Facility | None | $891.25 | $7,413.10 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,288.25 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $1,778.28 Median $3,311.31 Typical High $7,079.46 | Facility | None | $1,778.28 | $3,311.31 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,288.25 | $1,698.24 |
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 $954.99 Median $1,348.96 Typical High $2,398.83 | Professional | None | $954.99 | $1,348.96 | $2,398.83 |
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 $478.63 Median $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $218.78 | Professional | 53 · Discontinued | $194.98 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $724.44 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $109.65 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $758.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,659.59 Typical High $4,570.88 | Facility | 51 · Multiple procedures | $1,071.52 | $1,659.59 | $4,570.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $630.96 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $630.96 | $630.96 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $257.04 Typical High $562.34 | Professional | 80 · Assistant surgeon | $251.19 | $257.04 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $177.83 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $173.78 | $177.83 | $398.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $177.83 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $177.83 | $398.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $177.83 Typical High $398.11 | Professional | AS · PA/NP assist | $173.78 | $177.83 | $398.11 |
Where North Carolina sits
The same service costs 5.3 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 $15,900MT $3,027
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.