How much rates vary
Facilitymedian $4,266 · 10th to 90th $417 to $16,982Professionalmedian $417 · 10th to 90th $209 to $4,467
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 $371.54 Median $2,454.71 Typical High $7,413.10 | Facility | None | $371.54 | $2,454.71 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $2,454.71 | Professional | None | $371.54 | $501.19 | $2,454.71 |
BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $3,388.44 Typical High $8,709.64 | Facility | None | $2,187.76 | $3,388.44 | $8,709.64 |
BCBS Setting Professional Modifier None Typical Low $239.88 Median $467.74 Typical High $4,570.88 | Professional | None | $239.88 | $467.74 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $11,748.98 Typical High $16,982.44 | Facility | None | $457.09 | $11,748.98 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $3,162.28 | Professional | None | $186.21 | $229.09 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $5,754.40 | Professional | None | $323.59 | $323.59 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $2,454.71 Typical High $16,595.87 | Facility | None | $371.54 | $2,454.71 | $16,595.87 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $2,818.38 | Professional | None | $204.17 | $257.04 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $204.17 Median $426.58 Typical High $3,235.94 | Professional | None | $204.17 | $426.58 | $3,235.94 |
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 $186.21 Median $229.09 Typical High $1,230.27 | Professional | 52 · Reduced service | $186.21 | $229.09 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $91.20 Typical High $489.78 | Professional | 53 · Discontinued | $74.13 | $91.20 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $346.74 Typical High $1,862.09 | Professional | 54 · Surgery only | $275.42 | $346.74 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $69.18 Typical High $371.54 | Professional | 55 · Aftercare only | $56.23 | $69.18 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $45.71 Typical High $245.47 | Professional | 56 · Pre-op care only | $37.15 | $45.71 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $323.59 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $257.04 | $323.59 | $1,737.80 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $1,949.84 Typical High $8,709.64 | Facility | 51 · Multiple procedures | $186.21 | $1,949.84 | $8,709.64 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $128.82 Typical High $2,238.72 | Professional | 51 · Multiple procedures | $102.33 | $128.82 | $2,238.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $51.29 Typical High $912.01 | Professional | 80 · Assistant surgeon | $40.74 | $51.29 | $912.01 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.84 Median $35.48 Typical High $630.96 | Professional | 81 · Minimal assistant surgeon | $28.84 | $35.48 | $630.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.84 Median $35.48 Typical High $630.96 | Professional | 82 · Assistant surgeon, no resident | $28.84 | $35.48 | $630.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $35.48 Typical High $630.96 | Professional | AS · PA/NP assist | $28.84 | $35.48 | $630.96 |
Where North Carolina sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.