How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,202 to $9,120Professionalmedian $1,072 · 10th to 90th $794 to $2,188
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 $776.25 Median $1,288.25 Typical High $11,481.54 | Facility | None | $776.25 | $1,288.25 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,288.25 | Professional | None | $776.25 | $776.25 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $4,677.35 | Facility | None | $1,819.70 | $2,884.03 | $4,677.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,238.72 | Professional | None | $933.25 | $1,318.26 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $4,365.16 Typical High $7,244.36 | Facility | None | $1,258.93 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,949.84 | Professional | None | $812.83 | $870.96 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,174.90 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,318.26 | $3,162.28 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,737.80 | Professional | None | $891.25 | $977.24 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,949.84 | Professional | None | $660.69 | $851.14 | $1,949.84 |
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 $389.05 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $588.84 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $630.96 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $3,019.95 Median $4,677.35 Typical High $8,709.64 | Facility | 50 · Both sides | $3,019.95 | $4,677.35 | $8,709.64 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,584.89 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $1,000.00 | $1,584.89 | $2,884.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,445.44 Typical High $3,235.94 | Professional | 50 · Both sides | $1,348.96 | $1,445.44 | $3,235.94 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $489.78 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $446.68 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $194.98 Typical High $380.19 | Professional | 80 · Assistant surgeon | $181.97 | $194.98 | $380.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $125.89 Median $134.90 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $125.89 | $134.90 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $125.89 Median $134.90 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $125.89 | $134.90 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $134.90 Typical High $263.03 | Professional | AS · PA/NP assist | $125.89 | $134.90 | $263.03 |
Where North Carolina sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $10,315KY $2,095
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.