How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,096 to $22,909Professionalmedian $1,660 · 10th to 90th $1,122 to $3,090
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 $1,096.48 Median $1,584.89 Typical High $10,964.78 | Facility | None | $1,096.48 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,096.48 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $5,888.44 Median $8,317.64 Typical High $25,118.86 | Facility | None | $5,888.44 | $8,317.64 | $25,118.86 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,949.84 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $12,882.50 Typical High $20,417.38 | Facility | None | $602.56 | $12,882.50 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,230.27 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,778.28 | $1,778.28 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $27,542.29 Typical High $27,542.29 | Facility | None | $1,318.26 | $27,542.29 | $27,542.29 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,548.82 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,754.23 | Professional | None | $954.99 | $1,230.27 | $2,754.23 |
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 $549.54 Median $549.54 Typical High $645.65 | Professional | 52 · Reduced service | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | 53 · Discontinued | $218.78 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $954.99 | Professional | 54 · Surgery only | $831.76 | $831.76 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $128.82 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $891.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,511.89 Typical High $3,981.07 | Professional | 50 · Both sides | $2,089.30 | $2,511.89 | $3,981.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $851.14 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $691.83 | $851.14 | $1,348.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $338.84 Typical High $537.03 | Professional | 80 · Assistant surgeon | $275.42 | $338.84 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $234.42 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $194.98 | $234.42 | $371.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $234.42 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $234.42 | $371.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $371.54 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $371.54 |
Where North Carolina sits
The same service costs 10.4 times more in Alaska than in Kentucky. 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 $29,118KY $2,808
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.