How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,072 to $10,000Professionalmedian $2,042 · 10th to 90th $1,175 to $2,951
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 $1,071.52 Median $1,288.25 Typical High $10,471.29 | Facility | None | $1,071.52 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,071.52 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,691.53 Median $3,981.07 Typical High $5,370.32 | Facility | None | $2,691.53 | $3,981.07 | $5,370.32 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $2,951.21 | Professional | None | $1,412.54 | $2,187.76 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,365.16 Typical High $7,244.36 | Facility | None | $602.56 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,479.11 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,288.25 | $3,311.31 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,412.54 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,445.44 | $2,691.53 |
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 $537.03 Median $537.03 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $537.03 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | 53 · Discontinued | $213.80 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,000.00 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $131.83 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $933.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,137.96 Typical High $4,570.88 | Professional | 50 · Both sides | $1,949.84 | $2,137.96 | $4,570.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $707.95 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $660.69 | $707.95 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $281.84 Typical High $602.56 | Professional | 80 · Assistant surgeon | $263.03 | $281.84 | $602.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $199.53 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $181.97 | $199.53 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $199.53 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $199.53 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $199.53 Typical High $426.58 | Professional | AS · PA/NP assist | $181.97 | $199.53 | $426.58 |
Where North Carolina sits
The same service costs 3.4 times more in Alaska 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
AK $11,546MT $3,436
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.