How much rates vary
Facilitymedian $10,000 · 10th to 90th $759 to $23,442Professionalmedian $1,047 · 10th to 90th $708 to $1,862
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 $676.08 Median $912.01 Typical High $10,000.00 | Facility | None | $676.08 | $912.01 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $912.01 | Professional | None | $676.08 | $676.08 | $912.01 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,073.80 Median $6,309.57 Typical High $16,218.10 | Facility | None | $4,073.80 | $6,309.57 | $16,218.10 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,949.84 | Professional | None | $891.25 | $1,174.90 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $13,803.84 Typical High $19,952.62 | Facility | None | $645.65 | $13,803.84 | $19,952.62 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,659.59 | Professional | None | $758.58 | $776.25 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,148.15 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $2,754.23 Typical High $16,218.10 | Facility | None | $831.76 | $2,754.23 | $16,218.10 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,202.26 | Professional | None | $812.83 | $831.76 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,232.93 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,232.93 | $26,302.68 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,659.59 | Professional | None | $575.44 | $741.31 | $1,659.59 |
14 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 $331.13 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $537.03 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $12,882.50 Typical High $33,113.11 | Facility | 50 · Both sides | $1,258.93 | $12,882.50 | $33,113.11 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $4,365.16 Typical High $10,964.78 | Facility | 51 · Multiple procedures | $416.87 | $4,365.16 | $10,964.78 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,258.93 Typical High $2,454.71 | Professional | 50 · Both sides | $1,258.93 | $1,258.93 | $2,454.71 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $416.87 Typical High $812.83 | Professional | 51 · Multiple procedures | $416.87 | $416.87 | $812.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $165.96 Typical High $323.59 | Professional | 80 · Assistant surgeon | $165.96 | $165.96 | $323.59 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $117.49 Typical High $229.09 | Professional | 81 · Minimal assistant surgeon | $117.49 | $117.49 | $229.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $117.49 Typical High $229.09 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $117.49 | $229.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $117.49 Typical High $229.09 | Professional | AS · PA/NP assist | $117.49 | $117.49 | $229.09 |
Where North Carolina sits
The same service costs 10.6 times more in Alaska 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
AK $23,236MT $2,193
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.