How much rates vary
Facilitymedian $1,738 · 10th to 90th $676 to $6,166Professionalmedian $589 · 10th to 90th $407 to $1,230
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 $407.38 Median $1,000.00 Typical High $8,317.64 | Facility | None | $407.38 | $1,000.00 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $707.95 | Professional | None | $407.38 | $407.38 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $5,011.87 | Facility | None | $1,258.93 | $1,949.84 | $5,011.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,230.27 | Professional | None | $501.19 | $707.95 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $3,235.94 | Facility | None | $1,202.26 | $2,041.74 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $1,000.00 | Professional | None | $478.63 | $501.19 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $954.99 | Professional | None | $691.83 | $691.83 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $1,819.70 | Facility | None | $1,023.29 | $1,584.89 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $660.69 | Professional | None | $489.78 | $524.81 | $660.69 |
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 $346.74 Median $478.63 Typical High $1,000.00 | Professional | None | $346.74 | $478.63 | $1,000.00 |
10 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 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $323.59 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,548.82 Median $2,398.83 Typical High $4,365.16 | Facility | 50 · Both sides | $1,548.82 | $2,398.83 | $4,365.16 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $512.86 Median $794.33 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $512.86 | $794.33 | $1,445.44 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $794.33 Typical High $1,659.59 | Professional | 50 · Both sides | $794.33 | $794.33 | $1,659.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $263.03 Typical High $549.54 | Professional | 51 · Multiple procedures | $263.03 | $263.03 | $549.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $104.71 Typical High $223.87 | Professional | 80 · Assistant surgeon | $104.71 | $104.71 | $223.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $74.13 Typical High $154.88 | Professional | 81 · Minimal assistant surgeon | $74.13 | $74.13 | $154.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $74.13 Typical High $154.88 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $74.13 | $154.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $74.13 Typical High $154.88 | Professional | AS · PA/NP assist | $74.13 | $74.13 | $154.88 |
Where North Carolina sits
The same service costs 5.1 times more in Colorado 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
CO $6,741MT $1,322
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.