How much rates vary
Facilitymedian $2,188 · 10th to 90th $794 to $5,888Professionalmedian $1,122 · 10th to 90th $813 to $2,138
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 $794.33 Median $1,288.25 Typical High $8,317.64 | Facility | None | $794.33 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | None | $794.33 | $794.33 | $912.01 |
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 $831.76 Median $1,348.96 Typical High $2,187.76 | Professional | None | $831.76 | $1,348.96 | $2,187.76 |
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 $891.25 Median $933.25 Typical High $1,819.70 | Professional | None | $891.25 | $933.25 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,318.26 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $3,090.30 | Facility | None | $602.56 | $1,258.93 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,288.25 | Professional | None | $758.58 | $891.25 | $1,288.25 |
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 $645.65 Median $870.96 Typical High $1,949.84 | Professional | None | $645.65 | $870.96 | $1,949.84 |
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 $398.11 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $398.11 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $602.56 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $630.96 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $630.96 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $446.68 Typical High $933.25 | Professional | 51 · Multiple procedures | $380.19 | $446.68 | $933.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $177.83 Typical High $371.54 | Professional | 80 · Assistant surgeon | $154.88 | $177.83 | $371.54 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $125.89 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $107.15 | $125.89 | $263.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $125.89 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $125.89 | $263.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $125.89 Typical High $263.03 | Professional | AS · PA/NP assist | $107.15 | $125.89 | $263.03 |
Where North Carolina sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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 $7,619HI $2,493
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.