How much rates vary
Facilitymedian $2,188 · 10th to 90th $851 to $5,888Professionalmedian $1,259 · 10th to 90th $933 to $2,512
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 $912.01 Median $1,288.25 Typical High $8,317.64 | Facility | None | $912.01 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | None | $912.01 | $912.01 | $1,071.52 |
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 $1,148.15 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,584.89 | $2,570.40 |
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 $1,000.00 Median $1,047.13 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,047.13 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,513.56 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $3,388.44 | Facility | None | $602.56 | $1,258.93 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,513.56 | Professional | None | $954.99 | $1,096.48 | $1,513.56 |
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 $741.31 Median $977.24 Typical High $2,238.72 | Professional | None | $741.31 | $977.24 | $2,238.72 |
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 $457.09 Median $457.09 Typical High $489.78 | Professional | 52 · Reduced service | $457.09 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $691.83 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $691.83 |
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 $467.74 Median $549.54 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $467.74 | $549.54 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $218.78 Typical High $436.52 | Professional | 80 · Assistant surgeon | $199.53 | $218.78 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $154.88 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $138.04 | $154.88 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $154.88 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $154.88 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $154.88 Typical High $309.03 | Professional | AS · PA/NP assist | $138.04 | $154.88 | $309.03 |
Where North Carolina sits
The same service costs 3.1 times more in Alaska 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
AK $8,167HI $2,648
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.