How much rates vary
Facilitymedian $1,905 · 10th to 90th $851 to $5,754Professionalmedian $1,738 · 10th to 90th $1,230 to $3,090
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 $1,230.27 Median $1,445.44 Typical High $10,715.19 | Facility | None | $1,230.27 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,230.27 | $1,513.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $5,370.32 | Facility | None | $1,348.96 | $2,137.96 | $5,370.32 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,584.89 | $2,290.87 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $3,235.94 | Facility | None | $912.01 | $2,454.71 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,621.81 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,570.40 | Facility | None | $831.76 | $1,288.25 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,548.82 | $2,041.74 |
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 $1,202.26 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,479.11 | $3,019.95 |
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 $616.60 Median $616.60 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,047.13 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $645.65 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $416.87 | $645.65 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $776.25 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $758.58 | $776.25 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $316.23 Typical High $707.95 | Professional | 80 · Assistant surgeon | $302.00 | $316.23 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $218.78 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $213.80 | $218.78 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $218.78 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $218.78 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $218.78 Typical High $501.19 | Professional | AS · PA/NP assist | $213.80 | $218.78 | $501.19 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska than in Delaware. 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 $8,931DE $2,772
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.