How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $4,266 · 10th to 90th $2,344 to $6,607
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 $1,288.25 Median $2,290.87 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,290.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,630.78 | Professional | None | $2,290.87 | $2,290.87 | $3,630.78 |
Ambetter Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,311.31 Median $4,570.88 Typical High $7,079.46 | Professional | None | $3,311.31 | $4,570.88 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $6,309.57 | Professional | None | $2,344.23 | $3,388.44 | $6,309.57 |
Medcost Setting Facility Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $8,709.64 | Facility | None | $2,290.87 | $2,754.23 | $8,709.64 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $3,801.89 | Professional | None | $2,290.87 | $3,090.30 | $3,801.89 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $6,309.57 | Professional | None | $2,344.23 | $3,388.44 | $6,309.57 |
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 $1,148.15 Median $1,148.15 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $588.84 | Professional | 53 · Discontinued | $467.74 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $295.12 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $2,089.30 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,584.89 Typical High $3,388.44 | Professional | 51 · Multiple procedures | $1,148.15 | $1,584.89 | $3,388.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $630.96 Typical High $1,348.96 | Professional | 80 · Assistant surgeon | $467.74 | $630.96 | $1,348.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $446.68 Typical High $954.99 | Professional | 81 · Minimal assistant surgeon | $323.59 | $446.68 | $954.99 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $446.68 Typical High $954.99 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $446.68 | $954.99 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $446.68 Typical High $954.99 | Professional | AS · PA/NP assist | $323.59 | $446.68 | $954.99 |
Where North Carolina sits
The same service costs 7.2 times more in Alaska than in Washington. 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 $21,573WA $2,995
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.