How much rates vary
Facilitymedian $6,918 · 10th to 90th $912 to $12,882Professionalmedian $2,570 · 10th to 90th $1,585 to $4,365
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 $1,288.25 Median $1,548.82 Typical High $8,317.64 | Facility | None | $1,288.25 | $1,548.82 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,548.82 | $1,819.70 |
BCBS North Carolina Setting Facility Modifier None Typical Low $5,754.40 Median $8,511.38 Typical High $11,481.54 | Facility | None | $5,754.40 | $8,511.38 | $11,481.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $4,570.88 | Professional | None | $1,862.09 | $2,754.23 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $9,772.37 Typical High $16,218.10 | Facility | None | $602.56 | $9,772.37 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $3,890.45 | Professional | None | $1,698.24 | $1,778.28 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,630.78 | Professional | None | $2,570.40 | $2,570.40 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $8,709.64 Typical High $25,703.96 | Facility | None | $1,584.89 | $8,709.64 | $25,703.96 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,819.70 | $1,995.26 | $2,570.40 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $9,120.11 | Facility | None | $851.14 | $1,698.24 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $3,890.45 | Professional | None | $1,348.96 | $1,737.80 | $3,890.45 |
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 $776.25 Median $776.25 Typical High $891.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | 53 · Discontinued | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,258.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $2,951.21 Typical High $5,623.41 | Professional | 50 · Both sides | $2,754.23 | $2,951.21 | $5,623.41 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $1,000.00 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $912.01 | $1,000.00 | $1,862.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $398.11 Typical High $758.58 | Professional | 80 · Assistant surgeon | $363.08 | $398.11 | $758.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $275.42 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $257.04 | $275.42 | $524.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $275.42 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $275.42 | $524.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $275.42 Typical High $524.81 | Professional | AS · PA/NP assist | $257.04 | $275.42 | $524.81 |
Where North Carolina sits
The same service costs 6.3 times more in Alaska than in Texas. 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 $16,928TX $2,675
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.