How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,000 to $13,490Professionalmedian $1,175 · 10th to 90th $832 to $2,344
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 $831.76 Median $1,288.25 Typical High $8,317.64 | Facility | None | $831.76 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $977.24 | Professional | None | $831.76 | $831.76 | $977.24 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,981.07 Median $6,165.95 Typical High $15,848.93 | Facility | None | $3,981.07 | $6,165.95 | $15,848.93 |
BCBS North Carolina Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,398.83 | Professional | None | $870.96 | $1,380.38 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $5,495.41 Typical High $8,912.51 | Facility | None | $1,513.56 | $5,495.41 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $2,041.74 | Professional | None | $812.83 | $891.25 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,258.93 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $3,090.30 Typical High $10,964.78 | Facility | None | $954.99 | $3,090.30 | $10,964.78 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,412.54 | Professional | None | $912.01 | $1,047.13 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $2,137.96 | Professional | None | $724.44 | $954.99 | $2,137.96 |
11 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 $416.87 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $416.87 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $165.96 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $676.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $524.81 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $457.09 | $524.81 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $208.93 Typical High $416.87 | Professional | 80 · Assistant surgeon | $181.97 | $208.93 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $144.54 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $128.82 | $144.54 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $144.54 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $144.54 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $144.54 Typical High $295.12 | Professional | AS · PA/NP assist | $128.82 | $144.54 | $295.12 |
Where North Carolina sits
The same service costs 5.1 times more in Oklahoma 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
OK $11,738KY $2,311
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.