How much rates vary
Facilitymedian $269 · 10th to 90th $120 to $891Professionalmedian $891 · 10th to 90th $501 to $1,230
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 $501.19 Median $1,000.00 Typical High $7,943.28 | Facility | None | $501.19 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | None | $501.19 | $501.19 | $588.84 |
BCBS Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $371.54 | Facility | None | $186.21 | $275.42 | $371.54 |
BCBS Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,380.38 | Professional | None | $660.69 | $954.99 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $309.03 Typical High $588.84 | Facility | None | $194.98 | $309.03 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,000.00 | Professional | None | $512.86 | $660.69 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $501.19 | Facility | None | $144.54 | $223.87 | $501.19 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $831.76 | Professional | None | $588.84 | $660.69 | $831.76 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,230.27 | Professional | None | $478.63 | $660.69 | $1,230.27 |
11 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 $251.19 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $58.88 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $72.44 Median $112.20 Typical High $186.21 | Facility | 51 · Multiple procedures | $72.44 | $112.20 | $186.21 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $323.59 Typical High $741.31 | Professional | 51 · Multiple procedures | $295.12 | $323.59 | $741.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $131.83 Typical High $295.12 | Professional | 80 · Assistant surgeon | $117.49 | $131.83 | $295.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $83.18 Median $91.20 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $83.18 | $91.20 | $208.93 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $83.18 Median $91.20 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $83.18 | $91.20 | $208.93 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $91.20 Typical High $208.93 | Professional | AS · PA/NP assist | $83.18 | $91.20 | $208.93 |
Where North Carolina sits
The same service costs 3.2 times more in Wisconsin than in Arkansas. 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.
North Carolina· 13th of 51
$794
WI $1,380AR $427
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.