How much rates vary
Facilitymedian $871 · 10th to 90th $355 to $2,884Professionalmedian $776 · 10th to 90th $537 to $1,445
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 $512.86 Median $691.83 Typical High $7,413.10 | Facility | None | $512.86 | $691.83 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $851.14 | Professional | None | $512.86 | $512.86 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $707.95 | Professional | None | $426.58 | $707.95 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $446.68 Median $707.95 Typical High $1,778.28 | Facility | None | $446.68 | $707.95 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,513.56 | Professional | None | $630.96 | $933.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,819.70 Typical High $2,951.21 | Facility | None | $575.44 | $1,819.70 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $1,288.25 | Professional | None | $602.56 | $630.96 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Professional | None | $851.14 | $851.14 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $562.34 Typical High $2,884.03 | Facility | None | $380.19 | $562.34 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $851.14 | Professional | None | $616.60 | $660.69 | $851.14 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $1,258.93 | Professional | None | $436.52 | $602.56 | $1,258.93 |
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 $380.19 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $407.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $190.55 Median $281.84 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $190.55 | $281.84 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $331.13 Typical High $691.83 | Professional | 51 · Multiple procedures | $331.13 | $331.13 | $691.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $131.83 Typical High $281.84 | Professional | 80 · Assistant surgeon | $131.83 | $131.83 | $281.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $93.33 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $93.33 | $93.33 | $194.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $93.33 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $93.33 | $194.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $93.33 Typical High $194.98 | Professional | AS · PA/NP assist | $93.33 | $93.33 | $194.98 |
Where North Carolina sits
The same service costs 4.3 times more in Colorado 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
CO $5,853WV $1,353
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.