How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,239 · 10th to 90th $1,380 to $3,631
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 $1,230.27 Typical High $7,943.28 | Facility | None | $1,230.27 | $1,230.27 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,230.27 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $3,801.89 | Professional | None | $1,698.24 | $2,398.83 | $3,801.89 |
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 $1,479.11 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,819.70 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $4,265.80 | Facility | None | $1,202.26 | $1,479.11 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,698.24 | $2,511.89 |
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 $1,258.93 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,258.93 | $1,819.70 | $3,388.44 |
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 $776.25 | Professional | 52 · Reduced service | $616.60 | $616.60 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $309.03 | Professional | 53 · Discontinued | $245.47 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,174.90 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $154.88 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,096.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,511.89 Typical High $5,370.32 | Professional | 50 · Both sides | $1,819.70 | $2,511.89 | $5,370.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $831.76 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $616.60 | $831.76 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $338.84 Typical High $724.44 | Professional | 80 · Assistant surgeon | $245.47 | $338.84 | $724.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $234.42 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $169.82 | $234.42 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $234.42 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $234.42 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $234.42 Typical High $501.19 | Professional | AS · PA/NP assist | $169.82 | $234.42 | $501.19 |
Where North Carolina sits
The same service costs 6.4 times more in Alaska than in Maryland. 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 $12,091MD $1,881
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.