How much rates vary
Facilitymedian $1,778 · 10th to 90th $550 to $5,623Professionalmedian $692 · 10th to 90th $398 to $1,380
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 $398.11 Median $549.54 Typical High $6,760.83 | Facility | None | $398.11 | $549.54 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $645.65 | Professional | None | $398.11 | $549.54 | $645.65 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $6,165.95 | Facility | None | $1,412.54 | $1,949.84 | $6,165.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,548.82 | Professional | None | $537.03 | $831.76 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $3,235.94 | Facility | None | $645.65 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $1,202.26 | Professional | None | $309.03 | $478.63 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,348.96 | Professional | None | $676.08 | $676.08 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $2,398.83 | Facility | None | $575.44 | $977.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $933.25 | Professional | None | $537.03 | $660.69 | $933.25 |
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 $338.84 Median $549.54 Typical High $1,122.02 | Professional | None | $338.84 | $549.54 | $1,122.02 |
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 $199.53 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $199.53 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $79.43 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $295.12 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $58.88 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $39.81 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $275.42 | $371.54 | $407.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $588.84 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $588.84 | $1,698.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $331.13 Typical High $660.69 | Professional | 51 · Multiple procedures | $263.03 | $331.13 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $134.90 Typical High $263.03 | Professional | 80 · Assistant surgeon | $107.15 | $134.90 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $93.33 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $74.13 | $93.33 | $186.21 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $93.33 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $93.33 | $186.21 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $93.33 Typical High $186.21 | Professional | AS · PA/NP assist | $74.13 | $93.33 | $186.21 |
Where North Carolina sits
The same service costs 5.8 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 $8,423MT $1,458
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.