How much rates vary
Facilitymedian $3,236 · 10th to 90th $912 to $15,488Professionalmedian $1,445 · 10th to 90th $813 to $2,188
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 $776.25 Median $776.25 Typical High $7,943.28 | Facility | None | $776.25 | $776.25 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,288.25 | Professional | None | $776.25 | $776.25 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $1,202.26 Typical High $1,202.26 | Professional | None | $489.78 | $1,202.26 | $1,202.26 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,365.16 | Facility | None | $2,187.76 | $3,162.28 | $4,365.16 |
BCBS North Carolina Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,290.87 | Professional | None | $954.99 | $1,445.44 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,890.45 | Facility | None | $602.56 | $2,398.83 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,949.84 | Professional | None | $870.96 | $912.01 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,318.26 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $3,630.78 Typical High $6,165.95 | Facility | None | $794.33 | $3,630.78 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,584.89 | Professional | None | $954.99 | $1,148.15 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,471.29 Typical High $26,302.68 | Facility | None | $1,621.81 | $10,471.29 | $26,302.68 |
United Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,862.09 | Professional | None | $676.08 | $891.25 | $1,862.09 |
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 $389.05 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $154.88 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $630.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,862.09 Typical High $2,754.23 | Professional | 50 · Both sides | $1,548.82 | $1,862.09 | $2,754.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $616.60 Typical High $912.01 | Professional | 51 · Multiple procedures | $524.81 | $616.60 | $912.01 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $363.08 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $363.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $173.78 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $144.54 | $173.78 | $257.04 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $173.78 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $173.78 | $257.04 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $173.78 Typical High $257.04 | Professional | AS · PA/NP assist | $144.54 | $173.78 | $257.04 |
Where North Carolina sits
The same service costs 4.3 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 $9,769TX $2,271
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.