How much rates vary
Facilitymedian $1,905 · 10th to 90th $912 to $6,310Professionalmedian $1,230 · 10th to 90th $851 to $2,399
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 $851.14 Median $1,047.13 Typical High $5,248.07 | Facility | None | $851.14 | $1,047.13 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,698.24 | Professional | None | $851.14 | $1,047.13 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,096.48 | Professional | None | $912.01 | $954.99 | $1,096.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,148.15 | $1,698.24 | $2,290.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,584.89 Typical High $2,511.89 | Professional | None | $933.25 | $1,584.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,380.38 | $2,884.03 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,230.27 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,698.24 | $1,698.24 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,162.28 | Facility | None | $933.25 | $1,445.44 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,348.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $2,290.87 | Professional | None | $776.25 | $1,023.29 | $2,290.87 |
8 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 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $794.33 | Professional | 54 · Surgery only | $630.96 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $741.31 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $467.74 Median $724.44 Typical High $1,905.46 | Facility | 51 · Multiple procedures | $467.74 | $724.44 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $676.08 Typical High $851.14 | Professional | 51 · Multiple procedures | $512.86 | $676.08 | $851.14 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $269.15 Typical High $346.74 | Professional | 80 · Assistant surgeon | $204.17 | $269.15 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $186.21 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $141.25 | $186.21 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $186.21 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $186.21 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $186.21 Typical High $239.88 | Professional | AS · PA/NP assist | $141.25 | $186.21 | $239.88 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in West Virginia. 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
AK $8,334WV $2,168
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.