How much rates vary
Facilitymedian $2,630 · 10th to 90th $741 to $10,715Professionalmedian $891 · 10th to 90th $589 to $1,738
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 $630.96 Median $870.96 Typical High $8,511.38 | Facility | None | $630.96 | $870.96 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,096.48 | Professional | None | $630.96 | $630.96 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,754.23 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,819.70 | Professional | None | $588.84 | $1,096.48 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $7,413.10 Typical High $10,964.78 | Facility | None | $794.33 | $7,413.10 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $1,548.82 | Professional | None | $707.95 | $724.44 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,071.52 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $1,412.54 Typical High $5,754.40 | Facility | None | $724.44 | $1,412.54 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,047.13 | Professional | None | $758.58 | $870.96 | $1,047.13 |
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 $537.03 Median $707.95 Typical High $1,584.89 | Professional | None | $537.03 | $707.95 | $1,584.89 |
14 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 $316.23 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $501.19 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $2,137.96 Typical High $10,000.00 | Facility | 50 · Both sides | $1,096.48 | $2,137.96 | $10,000.00 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $707.95 Typical High $3,311.31 | Facility | 51 · Multiple procedures | $363.08 | $707.95 | $3,311.31 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,288.25 Typical High $2,290.87 | Professional | 50 · Both sides | $1,174.90 | $1,288.25 | $2,290.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $389.05 Median $426.58 Typical High $776.25 | Professional | 51 · Multiple procedures | $389.05 | $426.58 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $173.78 Typical High $309.03 | Professional | 80 · Assistant surgeon | $154.88 | $173.78 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $120.23 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $109.65 | $120.23 | $213.80 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $120.23 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $120.23 | $213.80 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $120.23 Typical High $213.80 | Professional | AS · PA/NP assist | $109.65 | $120.23 | $213.80 |
Where North Carolina sits
The same service costs 5.4 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 $11,142MT $2,070
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.