How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,122 to $11,220Professionalmedian $1,995 · 10th to 90th $1,230 to $3,715
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 $1,122.02 Median $1,445.44 Typical High $10,000.00 | Facility | None | $1,122.02 | $1,445.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,122.02 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,041.74 | $2,570.40 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $4,073.80 Typical High $6,456.54 | Facility | None | $2,511.89 | $4,073.80 | $6,456.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,584.89 | $2,754.23 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $6,165.95 Typical High $9,120.11 | Facility | None | $912.01 | $6,165.95 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,548.82 | $1,698.24 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $3,890.45 Typical High $10,000.00 | Facility | None | $831.76 | $3,890.45 | $10,000.00 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,862.09 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,466.84 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,466.84 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,698.24 | $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 $562.34 Median $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $851.14 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $870.96 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $5,888.44 Typical High $17,378.01 | Facility | 50 · Both sides | $1,258.93 | $5,888.44 | $17,378.01 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,949.84 Typical High $5,754.40 | Facility | 51 · Multiple procedures | $416.87 | $1,949.84 | $5,754.40 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,884.03 Typical High $5,128.61 | Professional | 50 · Both sides | $1,819.70 | $2,884.03 | $5,128.61 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $954.99 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $602.56 | $954.99 | $1,698.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $380.19 Typical High $676.08 | Professional | 80 · Assistant surgeon | $239.88 | $380.19 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $269.15 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $169.82 | $269.15 | $478.63 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $269.15 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $269.15 | $478.63 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $269.15 Typical High $478.63 | Professional | AS · PA/NP assist | $169.82 | $269.15 | $478.63 |
Where North Carolina sits
The same service costs 6.3 times more in Wyoming than in Hawaii. 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
WY $21,505HI $3,422
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.