How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $3,467 · 10th to 90th $2,344 to $6,761
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 $2,344.23 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,344.23 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,344.23 | $3,311.31 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,162.28 Median $4,677.35 Typical High $7,244.36 | Professional | None | $3,162.28 | $4,677.35 | $7,244.36 |
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 $1,905.46 Median $3,388.44 Typical High $6,456.54 | Professional | None | $1,905.46 | $3,388.44 | $6,456.54 |
Medcost Setting Facility Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $7,943.28 | Facility | None | $2,344.23 | $2,818.38 | $7,943.28 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,884.03 Typical High $3,890.45 | Professional | None | $2,137.96 | $2,884.03 | $3,890.45 |
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 $3,467.37 Typical High $6,456.54 | Professional | None | $2,344.23 | $3,467.37 | $6,456.54 |
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 $1,174.90 Median $1,174.90 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | 53 · Discontinued | $478.63 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $2,137.96 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 51 · Multiple procedures | $269.15 | $269.15 | $269.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,621.81 Typical High $3,467.37 | Professional | 51 · Multiple procedures | $1,071.52 | $1,621.81 | $3,467.37 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $645.65 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $426.58 | $645.65 | $1,380.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $446.68 Typical High $977.24 | Professional | 81 · Minimal assistant surgeon | $302.00 | $446.68 | $977.24 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $446.68 Typical High $977.24 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $446.68 | $977.24 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $446.68 Typical High $977.24 | Professional | AS · PA/NP assist | $302.00 | $446.68 | $977.24 |
Where North Carolina sits
The same service costs 7.1 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 $21,795WA $3,065
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.