How much rates vary
Facilitymedian $1,000 · 10th to 90th $263 to $2,692Professionalmedian $138 · 10th to 90th $58 to $324
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 $97.72 Median $138.04 Typical High $7,585.78 | Facility | None | $97.72 | $138.04 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $169.82 | Professional | None | $97.72 | $138.04 | $169.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $3,630.78 | Facility | None | $912.01 | $1,412.54 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $57.54 Median $141.25 Typical High $346.74 | Professional | None | $57.54 | $141.25 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $2,137.96 | Facility | None | $602.56 | $1,737.80 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $239.88 | Professional | None | $85.11 | $123.03 | $239.88 |
Medcost Setting Facility Modifier None Typical Low $154.88 Median $691.83 Typical High $1,513.56 | Facility | None | $154.88 | $691.83 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $190.55 | Professional | None | $131.83 | $151.36 | $190.55 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $251.19 | Professional | None | $100.00 | $134.90 | $251.19 |
13 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 $48.98 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $48.98 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $26.92 Typical High $28.18 | Professional | 53 · Discontinued | $19.50 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $100.00 Typical High $104.71 | Professional | 54 · Surgery only | $72.44 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $20.42 Typical High $21.38 | Professional | 55 · Aftercare only | $14.79 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.77 | $13.49 | $14.13 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,202.26 Typical High $3,235.94 | Facility | 50 · Both sides | $776.25 | $1,202.26 | $3,235.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $407.38 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $263.03 | $407.38 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $229.09 Typical High $309.03 | Professional | 50 · Both sides | $199.53 | $229.09 | $309.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $66.07 Median $75.86 Typical High $104.71 | Professional | 51 · Multiple procedures | $66.07 | $75.86 | $104.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.92 Median $30.20 Typical High $41.69 | Professional | 80 · Assistant surgeon | $26.92 | $30.20 | $41.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.62 Median $21.38 Typical High $28.84 | Professional | 81 · Minimal assistant surgeon | $18.62 | $21.38 | $28.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.62 Median $21.38 Typical High $28.84 | Professional | 82 · Assistant surgeon, no resident | $18.62 | $21.38 | $28.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $18.62 Median $21.38 Typical High $28.84 | Professional | AS · PA/NP assist | $18.62 | $21.38 | $28.84 |
Where North Carolina sits
The same service costs 10.9 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 $3,950MT $363
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.