How much rates vary
Facilitymedian $4,571 · 10th to 90th $871 to $17,378Professionalmedian $1,380 · 10th to 90th $912 to $2,455
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 $870.96 Median $1,047.13 Typical High $10,471.29 | Facility | None | $870.96 | $1,047.13 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,513.56 | Professional | None | $870.96 | $870.96 | $1,513.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,691.53 Median $3,715.35 Typical High $11,748.98 | Facility | None | $2,691.53 | $3,715.35 | $11,748.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,548.82 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $12,022.64 Typical High $17,782.79 | Facility | None | $794.33 | $12,022.64 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $2,187.76 | Professional | None | $977.24 | $1,023.29 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,479.11 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $15,488.17 | Facility | None | $741.31 | $2,290.87 | $15,488.17 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,258.93 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,265.80 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,265.80 | $17,782.79 |
United Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $2,187.76 | Professional | None | $758.58 | $977.24 | $2,187.76 |
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 $436.52 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $707.95 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $3,467.37 Typical High $28,840.32 | Facility | 50 · Both sides | $1,096.48 | $3,467.37 | $28,840.32 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $1,148.15 Typical High $9,772.37 | Facility | 51 · Multiple procedures | $363.08 | $1,148.15 | $9,772.37 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,187.76 Typical High $3,162.28 | Professional | 50 · Both sides | $1,621.81 | $2,187.76 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $724.44 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $549.54 | $724.44 | $1,071.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $295.12 Typical High $426.58 | Professional | 80 · Assistant surgeon | $218.78 | $295.12 | $426.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $204.17 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $151.36 | $204.17 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $204.17 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $204.17 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $204.17 Typical High $295.12 | Professional | AS · PA/NP assist | $151.36 | $204.17 | $295.12 |
Where North Carolina sits
The same service costs 6.8 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 $19,480MT $2,858
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.