How much rates vary
Facilitymedian $1,380 · 10th to 90th $389 to $3,388Professionalmedian $468 · 10th to 90th $229 to $851
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 $177.83 Median $323.59 Typical High $7,413.10 | Facility | None | $177.83 | $323.59 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $407.38 | Professional | None | $177.83 | $309.03 | $407.38 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,344.23 | Facility | None | $1,174.90 | $1,737.80 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $630.96 Typical High $954.99 | Professional | None | $295.12 | $630.96 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,318.26 Typical High $1,737.80 | Facility | None | $457.09 | $1,318.26 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $446.68 Typical High $660.69 | Professional | None | $229.09 | $446.68 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $794.33 | Professional | None | $645.65 | $645.65 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $1,584.89 | Facility | None | $371.54 | $602.56 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $870.96 | Professional | None | $309.03 | $426.58 | $870.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $616.60 | Professional | None | $173.78 | $323.59 | $616.60 |
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 $89.13 Median $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $89.13 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $35.48 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $223.87 Typical High $245.47 | Professional | 54 · Surgery only | $134.90 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $26.92 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.78 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $208.93 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $125.89 | $208.93 | $229.09 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,445.44 Typical High $2,818.38 | Facility | 50 · Both sides | $562.34 | $1,445.44 | $2,818.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $489.78 Typical High $933.25 | Facility | 51 · Multiple procedures | $186.21 | $489.78 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $630.96 Typical High $1,318.26 | Professional | 50 · Both sides | $467.74 | $630.96 | $1,318.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $154.88 Median $213.80 Typical High $436.52 | Professional | 51 · Multiple procedures | $154.88 | $213.80 | $436.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $85.11 Typical High $173.78 | Professional | 80 · Assistant surgeon | $61.66 | $85.11 | $173.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $43.65 Median $58.88 Typical High $123.03 | Professional | 81 · Minimal assistant surgeon | $43.65 | $58.88 | $123.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $43.65 Median $58.88 Typical High $123.03 | Professional | 82 · Assistant surgeon, no resident | $43.65 | $58.88 | $123.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $58.88 Typical High $123.03 | Professional | AS · PA/NP assist | $43.65 | $58.88 | $123.03 |
Where North Carolina sits
The same service costs 6.4 times more in Oklahoma than in North Dakota. 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
OK $5,125ND $804
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.