How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,380 to $12,882Professionalmedian $2,042 · 10th to 90th $1,318 to $3,236
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 $1,258.93 Median $1,380.38 Typical High $10,715.19 | Facility | None | $1,258.93 | $1,380.38 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,258.93 | $2,041.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,786.30 Median $7,413.10 Typical High $19,054.61 | Facility | None | $4,786.30 | $7,413.10 | $19,054.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,238.72 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $5,888.44 Typical High $9,549.93 | Facility | None | $1,698.24 | $5,888.44 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,445.44 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,187.76 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $5,888.44 | Facility | None | $2,454.71 | $2,454.71 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,513.56 | $1,778.28 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,570.88 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,570.88 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,513.56 | $3,090.30 |
14 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 $630.96 Median $630.96 Typical High $758.58 | Professional | 52 · Reduced service | $630.96 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,047.13 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $3,630.78 Median $3,715.35 Typical High $10,964.78 | Facility | 50 · Both sides | $3,630.78 | $3,715.35 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,230.27 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $1,230.27 | $1,230.27 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $3,311.31 Typical High $5,128.61 | Professional | 50 · Both sides | $2,398.83 | $3,311.31 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $794.33 Median $1,096.48 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $794.33 | $1,096.48 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $436.52 Typical High $676.08 | Professional | 80 · Assistant surgeon | $316.23 | $436.52 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $309.03 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $223.87 | $309.03 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $309.03 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $309.03 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $309.03 Typical High $478.63 | Professional | AS · PA/NP assist | $223.87 | $309.03 | $478.63 |
Where North Carolina sits
The same service costs 4.7 times more in Colorado than in Kentucky. 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 $15,002KY $3,224
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.