How much rates vary
Facilitymedian $2,188 · 10th to 90th $589 to $7,079Professionalmedian $813 · 10th to 90th $575 to $1,622
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 $524.81 Median $741.31 Typical High $10,232.93 | Facility | None | $524.81 | $741.31 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,000.00 | Professional | None | $524.81 | $524.81 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,621.81 Median $2,511.89 Typical High $6,456.54 | Facility | None | $1,621.81 | $2,511.89 | $6,456.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,698.24 | Professional | None | $660.69 | $954.99 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $3,235.94 | Facility | None | $645.65 | $2,290.87 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,380.38 | Professional | None | $645.65 | $660.69 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,258.93 | Professional | None | $977.24 | $977.24 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $1,288.25 Typical High $2,511.89 | Facility | None | $588.84 | $1,288.25 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,230.27 | Professional | None | $676.08 | $812.83 | $1,230.27 |
Oscar Health Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $13,803.84 | Facility | None | $1,862.09 | $1,862.09 | $13,803.84 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,691.53 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,691.53 | $12,022.64 |
United Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,318.26 | Professional | None | $478.63 | $630.96 | $1,318.26 |
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 $263.03 Median $263.03 Typical High $309.03 | Professional | 52 · Reduced service | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $467.74 | Professional | 54 · Surgery only | $398.11 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $61.66 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $436.52 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,949.84 Typical High $5,011.87 | Facility | 50 · Both sides | $891.25 | $1,949.84 | $5,011.87 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $645.65 Typical High $1,698.24 | Facility | 51 · Multiple procedures | $295.12 | $645.65 | $1,698.24 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,412.54 Typical High $1,949.84 | Professional | 50 · Both sides | $1,047.13 | $1,412.54 | $1,949.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $346.74 Median $467.74 Typical High $645.65 | Professional | 51 · Multiple procedures | $346.74 | $467.74 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $186.21 Typical High $257.04 | Professional | 80 · Assistant surgeon | $141.25 | $186.21 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $97.72 Median $131.83 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $97.72 | $131.83 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $97.72 Median $131.83 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $97.72 | $131.83 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $131.83 Typical High $181.97 | Professional | AS · PA/NP assist | $97.72 | $131.83 | $181.97 |
Where North Carolina sits
The same service costs 4.7 times more in Connecticut 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
CT $8,304MT $1,762
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.