How much rates vary
Facilitymedian $1,905 · 10th to 90th $617 to $5,754Professionalmedian $955 · 10th to 90th $479 to $1,349
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 $467.74 Median $1,047.13 Typical High $8,317.64 | Facility | None | $467.74 | $1,047.13 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $794.33 | Professional | None | $467.74 | $467.74 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,786.30 | Facility | None | $1,202.26 | $1,862.09 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,348.96 | Professional | None | $575.44 | $1,000.00 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $1,148.15 | Professional | None | $524.81 | $537.03 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,096.48 | Professional | None | $794.33 | $794.33 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $954.99 Typical High $2,398.83 | Facility | None | $575.44 | $954.99 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $776.25 | Professional | None | $489.78 | $575.44 | $776.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $1,174.90 | Professional | None | $398.11 | $524.81 | $1,174.90 |
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 $234.42 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $346.74 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $371.54 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $288.40 Typical High $562.34 | Professional | 51 · Multiple procedures | $245.47 | $288.40 | $562.34 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $223.87 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $81.28 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $69.18 | $81.28 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $81.28 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $81.28 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $81.28 Typical High $158.49 | Professional | AS · PA/NP assist | $69.18 | $81.28 | $158.49 |
Where North Carolina sits
The same service costs 4.6 times more in Alabama than in Montana. 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
AL $7,006MT $1,517
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.