How much rates vary
Facilitymedian $1,950 · 10th to 90th $562 to $7,586Professionalmedian $724 · 10th to 90th $490 to $1,349
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 $457.09 Median $933.25 Typical High $7,943.28 | Facility | None | $457.09 | $933.25 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $851.14 | Professional | None | $457.09 | $457.09 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $436.52 | Professional | None | $295.12 | $295.12 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $5,248.07 | Facility | None | $1,202.26 | $1,698.24 | $5,248.07 |
BCBS North Carolina Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,412.54 | Professional | None | $588.84 | $870.96 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,011.87 Typical High $7,413.10 | Facility | None | $602.56 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,174.90 | Professional | None | $575.44 | $575.44 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,071.52 | Professional | None | $870.96 | $870.96 | $1,071.52 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $977.24 Typical High $5,248.07 | Facility | None | $524.81 | $977.24 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,047.13 | Professional | None | $562.34 | $691.83 | $1,047.13 |
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 $398.11 Median $549.54 Typical High $1,174.90 | Professional | None | $398.11 | $549.54 | $1,174.90 |
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 $229.09 Median $229.09 Typical High $269.15 | Professional | 52 · Reduced service | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | 53 · Discontinued | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $346.74 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $79.43 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $371.54 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $489.78 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $263.03 | $489.78 | $3,715.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $371.54 Typical High $645.65 | Professional | 51 · Multiple procedures | $302.00 | $371.54 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $147.91 Typical High $257.04 | Professional | 80 · Assistant surgeon | $120.23 | $147.91 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $85.11 Median $104.71 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $85.11 | $104.71 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $85.11 Median $104.71 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $85.11 | $104.71 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $104.71 Typical High $177.83 | Professional | AS · PA/NP assist | $85.11 | $104.71 | $177.83 |
Where North Carolina sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.