How much rates vary
Facilitymedian $1,349 · 10th to 90th $447 to $5,129Professionalmedian $724 · 10th to 90th $389 to $1,622
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 $338.84 Median $630.96 Typical High $7,413.10 | Facility | None | $338.84 | $630.96 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $616.60 Typical High $676.08 | Professional | None | $338.84 | $616.60 | $676.08 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,621.81 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,659.59 | Professional | None | $501.19 | $812.83 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,348.96 Typical High $1,905.46 | Facility | None | $457.09 | $1,348.96 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $660.69 Typical High $1,202.26 | Professional | None | $363.08 | $660.69 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,548.82 | Professional | None | $954.99 | $954.99 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $831.76 Typical High $1,445.44 | Facility | None | $371.54 | $831.76 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,174.90 | Professional | None | $602.56 | $741.31 | $1,174.90 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $1,174.90 | Professional | None | $331.13 | $588.84 | $1,174.90 |
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 $169.82 Median $281.84 Typical High $331.13 | Professional | 52 · Reduced service | $169.82 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $114.82 Typical High $131.83 | Professional | 53 · Discontinued | $67.61 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $257.04 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $85.11 Typical High $100.00 | Professional | 55 · Aftercare only | $51.29 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $56.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $33.88 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $239.88 | $398.11 | $457.09 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,230.27 Typical High $3,162.28 | Facility | 50 · Both sides | $562.34 | $1,230.27 | $3,162.28 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $416.87 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $186.21 | $416.87 | $1,047.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,096.48 Typical High $2,344.23 | Professional | 50 · Both sides | $912.01 | $1,096.48 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $371.54 Typical High $776.25 | Professional | 51 · Multiple procedures | $302.00 | $371.54 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $147.91 Typical High $316.23 | Professional | 80 · Assistant surgeon | $120.23 | $147.91 | $316.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $102.33 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $85.11 | $102.33 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $102.33 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $102.33 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $218.78 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $218.78 |
Where North Carolina sits
The same service costs 3.2 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 $4,968MT $1,567
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.