How much rates vary
Facilitymedian $2,455 · 10th to 90th $871 to $9,333Professionalmedian $1,413 · 10th to 90th $891 to $2,344
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 $870.96 Median $1,288.25 Typical High $10,471.29 | Facility | None | $870.96 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,548.82 | Professional | None | $870.96 | $870.96 | $1,548.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $3,090.30 | Facility | None | $1,548.82 | $2,290.87 | $3,090.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,513.56 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $6,309.57 Typical High $9,332.54 | Facility | None | $794.33 | $6,309.57 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,995.26 | Professional | None | $977.24 | $1,023.29 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,445.44 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $1,258.93 Typical High $7,079.46 | Facility | None | $741.31 | $1,258.93 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,412.54 | Professional | None | $891.25 | $1,023.29 | $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 $707.95 Median $933.25 Typical High $2,137.96 | Professional | None | $707.95 | $933.25 | $2,137.96 |
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 $436.52 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $173.78 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $660.69 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $630.96 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $363.08 | $630.96 | $3,715.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $512.86 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $446.68 | $512.86 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $208.93 Typical High $416.87 | Professional | 80 · Assistant surgeon | $186.21 | $208.93 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $144.54 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $128.82 | $144.54 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $144.54 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $144.54 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $144.54 Typical High $288.40 | Professional | AS · PA/NP assist | $128.82 | $144.54 | $288.40 |
Where North Carolina sits
The same service costs 4.5 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 $12,963MT $2,892
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.