How much rates vary
Facilitymedian $2,291 · 10th to 90th $794 to $5,888Professionalmedian $832 · 10th to 90th $525 to $1,445
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 $489.78 Median $1,288.25 Typical High $10,471.29 | Facility | None | $489.78 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $724.44 | Professional | None | $489.78 | $489.78 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $3,311.31 | Facility | None | $1,318.26 | $2,137.96 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $977.24 Typical High $1,445.44 | Professional | None | $588.84 | $977.24 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $3,235.94 | Facility | None | $794.33 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,202.26 | Professional | None | $588.84 | $812.83 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,412.54 Typical High $2,691.53 | Facility | None | $707.95 | $1,412.54 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,412.54 | Professional | None | $575.44 | $645.65 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $1,230.27 | Professional | None | $407.38 | $602.56 | $1,230.27 |
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 $239.88 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $389.05 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $707.95 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $363.08 | $707.95 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $288.40 Median $323.59 Typical High $707.95 | Professional | 51 · Multiple procedures | $288.40 | $323.59 | $707.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $128.82 Typical High $281.84 | Professional | 80 · Assistant surgeon | $114.82 | $128.82 | $281.84 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $79.43 Median $91.20 Typical High $199.53 | Professional | 81 · Minimal assistant surgeon | $79.43 | $91.20 | $199.53 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $79.43 Median $91.20 Typical High $199.53 | Professional | 82 · Assistant surgeon, no resident | $79.43 | $91.20 | $199.53 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $91.20 Typical High $199.53 | Professional | AS · PA/NP assist | $79.43 | $91.20 | $199.53 |
Where North Carolina sits
The same service costs 4.5 times more in Wisconsin 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
WI $7,285MT $1,607
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.