How much rates vary
Facilitymedian $4,266 · 10th to 90th $955 to $8,318Professionalmedian $1,549 · 10th to 90th $1,122 to $2,818
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 $1,047.13 Median $1,288.25 Typical High $10,471.29 | Facility | None | $1,047.13 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,047.13 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $8,317.64 | Facility | None | $3,981.07 | $5,888.44 | $8,317.64 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,230.27 | $2,041.74 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,365.16 Typical High $7,244.36 | Facility | None | $741.31 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,479.11 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $4,265.80 Typical High $8,912.51 | Facility | None | $1,047.13 | $4,265.80 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,445.44 | $1,995.26 |
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 $1,047.13 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,047.13 | $1,348.96 | $2,630.27 |
11 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 $524.81 Median $524.81 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 53 · Discontinued | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $891.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $724.44 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $691.83 | $724.44 | $1,513.56 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $288.40 Typical High $602.56 | Professional | 80 · Assistant surgeon | $275.42 | $288.40 | $602.56 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $204.17 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $194.98 | $204.17 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $204.17 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $204.17 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $204.17 Typical High $426.58 | Professional | AS · PA/NP assist | $194.98 | $204.17 | $426.58 |
Where North Carolina sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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 $11,283KY $2,440
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.