How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,455 · 10th to 90th $1,698 to $4,571
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 $1,584.89 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,584.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,584.89 | $1,995.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $4,897.79 | Professional | None | $2,187.76 | $2,884.03 | $4,897.79 |
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 $1,862.09 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,344.23 | $4,365.16 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $4,168.69 | Facility | None | $1,584.89 | $1,905.46 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,548.82 | $1,995.26 | $3,162.28 |
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 $1,621.81 Median $2,290.87 Typical High $4,265.80 | Professional | None | $1,621.81 | $2,290.87 | $4,265.80 |
13 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 $794.33 Median $794.33 Typical High $1,000.00 | Professional | 52 · Reduced service | $794.33 | $794.33 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $407.38 | Professional | 53 · Discontinued | $316.23 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $199.53 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,412.54 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $457.09 | $457.09 | $457.09 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $3,235.94 Typical High $6,918.31 | Professional | 50 · Both sides | $2,344.23 | $3,235.94 | $6,918.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $1,071.52 Typical High $2,290.87 | Professional | 51 · Multiple procedures | $776.25 | $1,071.52 | $2,290.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $426.58 Typical High $933.25 | Professional | 80 · Assistant surgeon | $309.03 | $426.58 | $933.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $302.00 Typical High $645.65 | Professional | 81 · Minimal assistant surgeon | $218.78 | $302.00 | $645.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $302.00 Typical High $645.65 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $302.00 | $645.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $302.00 Typical High $645.65 | Professional | AS · PA/NP assist | $218.78 | $302.00 | $645.65 |
Where North Carolina sits
The same service costs 8.2 times more in Alabama 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
AL $19,170WA $2,342
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.