How much rates vary
Facilitymedian $933 · 10th to 90th $398 to $2,951Professionalmedian $631 · 10th to 90th $302 to $1,096
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 $257.04 Median $1,000.00 Typical High $7,943.28 | Facility | None | $257.04 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $380.19 | Professional | None | $257.04 | $257.04 | $380.19 |
BCBS North Carolina Setting Facility Modifier None Typical Low $524.81 Median $831.76 Typical High $2,089.30 | Facility | None | $524.81 | $831.76 | $2,089.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $354.81 Median $691.83 Typical High $1,148.15 | Professional | None | $354.81 | $691.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,202.26 Typical High $1,479.11 | Facility | None | $457.09 | $1,202.26 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $851.14 | Professional | None | $309.03 | $457.09 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $1,148.15 Typical High $1,148.15 | Professional | None | $588.84 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $1,258.93 | Facility | None | $371.54 | $489.78 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $602.56 | Professional | None | $323.59 | $389.05 | $602.56 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $891.25 | Professional | None | $229.09 | $363.08 | $891.25 |
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 $128.82 Median $128.82 Typical High $154.88 | Professional | 52 · Reduced service | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | 53 · Discontinued | $51.29 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | 54 · Surgery only | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $30.90 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $30.90 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $251.19 Typical High $724.44 | Facility | 51 · Multiple procedures | $186.21 | $251.19 | $724.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $257.04 Typical High $363.08 | Professional | 51 · Multiple procedures | $169.82 | $257.04 | $363.08 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $109.65 Typical High $144.54 | Professional | 80 · Assistant surgeon | $69.18 | $109.65 | $144.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $47.86 Median $77.62 Typical High $102.33 | Professional | 81 · Minimal assistant surgeon | $47.86 | $77.62 | $102.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $47.86 Median $77.62 Typical High $102.33 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $77.62 | $102.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $77.62 Typical High $102.33 | Professional | AS · PA/NP assist | $47.86 | $77.62 | $102.33 |
Where North Carolina sits
The same service costs 6.0 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 $4,737MT $787
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.