How much rates vary
Facilitymedian $13,490 · 10th to 90th $1,660 to $23,988Professionalmedian $3,631 · 10th to 90th $1,862 to $5,129
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 $1,584.89 Median $1,737.80 Typical High $11,481.54 | Facility | None | $1,584.89 | $1,737.80 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $10,471.29 Median $15,488.17 Typical High $20,892.96 | Facility | None | $10,471.29 | $15,488.17 | $20,892.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $5,128.61 | Professional | None | $2,344.23 | $3,630.78 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $17,378.01 Typical High $28,840.32 | Facility | None | $602.56 | $17,378.01 | $28,840.32 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $4,466.84 | Professional | None | $2,137.96 | $2,344.23 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $8,709.64 Median $13,489.63 Typical High $30,199.52 | Facility | None | $8,709.64 | $13,489.63 | $30,199.52 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $2,818.38 | Professional | None | $2,137.96 | $2,344.23 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,964.78 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,964.78 | $26,302.68 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $4,265.80 | Professional | None | $1,513.56 | $2,137.96 | $4,265.80 |
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 $870.96 Median $870.96 Typical High $1,000.00 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | 53 · Discontinued | $346.74 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,412.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $12,882.50 Median $19,952.62 Typical High $45,708.82 | Facility | 50 · Both sides | $12,882.50 | $19,952.62 | $45,708.82 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $4,365.16 Median $6,760.83 Typical High $15,135.61 | Facility | 51 · Multiple procedures | $4,365.16 | $6,760.83 | $15,135.61 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,467.37 Median $3,548.13 Typical High $6,309.57 | Professional | 50 · Both sides | $3,467.37 | $3,548.13 | $6,309.57 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,174.90 Median $1,174.90 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $1,174.90 | $1,174.90 | $2,089.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $467.74 Typical High $831.76 | Professional | 80 · Assistant surgeon | $467.74 | $467.74 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $331.13 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $323.59 | $331.13 | $588.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $331.13 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $331.13 | $588.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $331.13 Typical High $588.84 | Professional | AS · PA/NP assist | $323.59 | $331.13 | $588.84 |
Where North Carolina sits
The same service costs 7.8 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 $31,233KY $3,989
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.