How much rates vary
Facilitymedian $3,090 · 10th to 90th $871 to $10,471Professionalmedian $1,122 · 10th to 90th $661 to $1,862
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 $630.96 Median $630.96 Typical High $7,943.28 | Facility | None | $630.96 | $630.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | None | $630.96 | $630.96 | $741.31 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $4,570.88 | Facility | None | $2,187.76 | $3,235.94 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,862.09 | Professional | None | $831.76 | $1,174.90 | $1,862.09 |
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 $758.58 Median $794.33 Typical High $1,621.81 | Professional | None | $758.58 | $794.33 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,202.26 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $3,090.30 Typical High $6,165.95 | Facility | None | $630.96 | $3,090.30 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,122.02 | Professional | None | $776.25 | $912.01 | $1,122.02 |
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 $549.54 Median $776.25 Typical High $1,479.11 | Professional | None | $549.54 | $776.25 | $1,479.11 |
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 $316.23 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $512.86 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,548.82 Typical High $2,187.76 | Professional | 50 · Both sides | $1,318.26 | $1,548.82 | $2,187.76 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $512.86 Typical High $724.44 | Professional | 51 · Multiple procedures | $436.52 | $512.86 | $724.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $288.40 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $288.40 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $144.54 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $123.03 | $144.54 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $144.54 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $144.54 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $204.17 |
Where North Carolina sits
The same service costs 6.1 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 $11,046MT $1,825
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.