How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,380 to $12,882Professionalmedian $3,715 · 10th to 90th $2,399 to $6,607
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 $1,445.44 Median $2,398.83 Typical High $10,715.19 | Facility | None | $1,445.44 | $2,398.83 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,715.35 | Professional | None | $2,398.83 | $2,398.83 | $3,715.35 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,897.79 Median $7,244.36 Typical High $9,772.37 | Facility | None | $4,897.79 | $7,244.36 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,019.95 Median $4,073.80 Typical High $6,918.31 | Professional | None | $3,019.95 | $4,073.80 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $8,709.64 | Facility | None | $602.56 | $5,370.32 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $5,888.44 | Professional | None | $2,398.83 | $2,570.40 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,623.41 | Professional | None | $3,715.35 | $3,715.35 | $5,623.41 |
Medcost Setting Facility Modifier None Typical Low $2,398.83 Median $10,000.00 Typical High $13,803.84 | Facility | None | $2,398.83 | $10,000.00 | $13,803.84 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,235.94 Typical High $3,890.45 | Professional | None | $2,884.03 | $3,235.94 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $5,888.44 | Professional | None | $2,041.74 | $2,630.27 | $5,888.44 |
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 $1,202.26 Median $1,202.26 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 53 · Discontinued | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,949.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,819.70 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $1,445.44 | $1,819.70 | $2,884.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $724.44 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $588.84 | $724.44 | $1,148.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $512.86 Typical High $794.33 | Professional | 81 · Minimal assistant surgeon | $407.38 | $512.86 | $794.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $512.86 Typical High $794.33 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $512.86 | $794.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $512.86 Typical High $794.33 | Professional | AS · PA/NP assist | $407.38 | $512.86 | $794.33 |
Where North Carolina sits
The same service costs 4.0 times more in Alaska than in Texas. 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 $19,772TX $4,915
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.