How much rates vary
Facilitymedian $3,020 · 10th to 90th $912 to $10,715Professionalmedian $1,479 · 10th to 90th $891 to $2,399
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 $831.76 Median $831.76 Typical High $7,943.28 | Facility | None | $831.76 | $831.76 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $977.24 | Professional | None | $831.76 | $831.76 | $977.24 |
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 $1,047.13 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,548.82 | $2,511.89 |
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 $1,000.00 Median $1,000.00 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,000.00 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,479.11 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $6,165.95 | Facility | None | $831.76 | $3,801.89 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,230.27 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $2,041.74 | Professional | None | $724.44 | $977.24 | $2,041.74 |
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 $416.87 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $165.96 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $676.08 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,905.46 Typical High $2,884.03 | Professional | 50 · Both sides | $1,659.59 | $1,905.46 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $630.96 Typical High $977.24 | Professional | 51 · Multiple procedures | $562.34 | $630.96 | $977.24 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $251.19 Typical High $389.05 | Professional | 80 · Assistant surgeon | $223.87 | $251.19 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $177.83 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $154.88 | $177.83 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $177.83 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $177.83 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $177.83 Typical High $269.15 | Professional | AS · PA/NP assist | $154.88 | $177.83 | $269.15 |
Where North Carolina sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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 $11,256KY $2,261
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.