How much rates vary
Facilitymedian $10,471 · 10th to 90th $1,479 to $21,878Professionalmedian $2,512 · 10th to 90th $1,479 to $4,074
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 $1,479.11 Median $1,584.89 Typical High $10,964.78 | Facility | None | $1,479.11 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,479.11 | $1,737.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $6,760.83 Median $11,220.18 Typical High $17,378.01 | Facility | None | $6,760.83 | $11,220.18 | $17,378.01 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,570.40 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $9,772.37 Typical High $16,218.10 | Facility | None | $602.56 | $9,772.37 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $3,630.78 | Professional | None | $1,548.82 | $1,621.81 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,467.37 | Professional | None | $2,398.83 | $2,398.83 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $5,754.40 Typical High $25,703.96 | Facility | None | $1,621.81 | $5,754.40 | $25,703.96 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,778.28 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $3,630.78 | Professional | None | $1,258.93 | $1,621.81 | $3,630.78 |
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 $741.31 Median $741.31 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $891.25 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $831.76 | $891.25 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $363.08 Typical High $707.95 | Professional | 80 · Assistant surgeon | $331.13 | $363.08 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $251.19 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $229.09 | $251.19 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $251.19 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $251.19 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $251.19 Typical High $501.19 | Professional | AS · PA/NP assist | $229.09 | $251.19 | $501.19 |
Where North Carolina sits
The same service costs 6.3 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 $21,445KY $3,429
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.