How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,380 to $12,882Professionalmedian $1,585 · 10th to 90th $1,047 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 $1,288.25 Median $1,479.11 Typical High $10,715.19 | Facility | None | $1,288.25 | $1,479.11 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,479.11 | $1,479.11 | $1,698.24 |
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 $1,318.26 Median $1,737.80 Typical High $4,168.69 | Professional | None | $1,318.26 | $1,737.80 | $4,168.69 |
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 $977.24 Median $1,122.02 Typical High $3,311.31 | Professional | None | $977.24 | $1,122.02 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,467.37 | Professional | None | $1,621.81 | $1,621.81 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $13,803.84 | Facility | None | $1,513.56 | $3,801.89 | $13,803.84 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,659.59 | $2,344.23 |
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 $977.24 Median $1,479.11 Typical High $3,630.78 | Professional | None | $977.24 | $1,479.11 | $3,630.78 |
12 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 50 · Both sides Typical Low $1,905.46 Median $2,454.71 Typical High $5,370.32 | Professional | 50 · Both sides | $1,905.46 | $2,454.71 | $5,370.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $812.83 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $630.96 | $812.83 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $331.13 Typical High $707.95 | Professional | 80 · Assistant surgeon | $251.19 | $331.13 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $229.09 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $177.83 | $229.09 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $229.09 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $229.09 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $229.09 Typical High $501.19 | Professional | AS · PA/NP assist | $177.83 | $229.09 | $501.19 |
Where North Carolina sits
The same service costs 5.5 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 $15,938KY $2,890
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.