How much rates vary
Facilitymedian $2,630 · 10th to 90th $776 to $9,333Professionalmedian $1,175 · 10th to 90th $759 to $2,188
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 $575.44 Median $977.24 Typical High $5,248.07 | Facility | None | $575.44 | $977.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $1,348.96 | Professional | None | $575.44 | $954.99 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | None | $741.31 | $891.25 | $891.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $7,762.47 | Facility | None | $1,778.28 | $2,454.71 | $7,762.47 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,445.44 Typical High $2,290.87 | Professional | None | $891.25 | $1,445.44 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $6,456.54 Typical High $9,332.54 | Facility | None | $912.01 | $6,456.54 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,905.46 | Professional | None | $776.25 | $912.01 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,318.26 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,445.44 Typical High $5,248.07 | Facility | None | $812.83 | $1,445.44 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,584.89 | Professional | None | $954.99 | $1,096.48 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,630.27 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,630.27 | $12,022.64 |
United Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $1,905.46 | Professional | None | $562.34 | $912.01 | $1,905.46 |
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 $288.40 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $288.40 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $181.97 Typical High $194.98 | Professional | 53 · Discontinued | $114.82 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $426.58 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $87.10 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $91.20 Typical High $97.72 | Professional | 56 · Pre-op care only | $57.54 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $398.11 | $630.96 | $691.83 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,258.93 Median $2,290.87 Typical High $7,943.28 | Facility | 50 · Both sides | $1,258.93 | $2,290.87 | $7,943.28 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $758.58 Typical High $2,630.27 | Facility | 51 · Multiple procedures | $416.87 | $758.58 | $2,630.27 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,621.81 Typical High $3,548.13 | Professional | 50 · Both sides | $1,412.54 | $1,621.81 | $3,548.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $537.03 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $467.74 | $537.03 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $218.78 Typical High $467.74 | Professional | 80 · Assistant surgeon | $190.55 | $218.78 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $134.90 Median $151.36 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $134.90 | $151.36 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $134.90 Median $151.36 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $134.90 | $151.36 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $151.36 Typical High $331.13 | Professional | AS · PA/NP assist | $134.90 | $151.36 | $331.13 |
Where North Carolina sits
The same service costs 5.1 times more in Alaska than in West Virginia. 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 $10,217WV $2,002
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.