How much rates vary
Facilitymedian $2,239 · 10th to 90th $617 to $7,762Professionalmedian $912 · 10th to 90th $550 to $1,514
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 $512.86 Median $1,584.89 Typical High $10,964.78 | Facility | None | $512.86 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $912.01 | Professional | None | $512.86 | $512.86 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $446.68 | Professional | None | $60.26 | $60.26 | $446.68 |
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 $912.01 Typical High $1,548.82 | Professional | None | $660.69 | $912.01 | $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 $588.84 Median $602.56 Typical High $1,288.25 | Professional | None | $588.84 | $602.56 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,230.27 | Professional | None | $912.01 | $912.01 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $1,288.25 Typical High $2,398.83 | Facility | None | $575.44 | $1,288.25 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $851.14 | Professional | None | $616.60 | $645.65 | $851.14 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,288.25 | Professional | None | $446.68 | $575.44 | $1,288.25 |
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 $257.04 Median $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $416.87 |
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 $954.99 Median $977.24 Typical High $1,862.09 | Professional | 50 · Both sides | $954.99 | $977.24 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $323.59 Typical High $616.60 | Professional | 51 · Multiple procedures | $323.59 | $323.59 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $128.82 Typical High $251.19 | Professional | 80 · Assistant surgeon | $128.82 | $128.82 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $91.20 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $89.13 | $91.20 | $173.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $91.20 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $91.20 | $173.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $91.20 Typical High $173.78 | Professional | AS · PA/NP assist | $89.13 | $91.20 | $173.78 |
Where North Carolina sits
The same service costs 4.5 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 $7,632MT $1,703
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.