How much rates vary
Facilitymedian $912 · 10th to 90th $389 to $7,079Professionalmedian $1,585 · 10th to 90th $1,148 to $3,090
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 $1,071.52 Median $1,071.52 Typical High $7,943.28 | Facility | None | $1,071.52 | $1,071.52 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,071.52 | $1,778.28 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,995.26 | $3,235.94 |
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 $1,148.15 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,548.82 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $602.56 Typical High $1,862.09 | Facility | None | $389.05 | $602.56 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,348.96 | $1,862.09 |
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 $1,096.48 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,548.82 | $2,951.21 |
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 $537.03 Median $537.03 Typical High $724.44 | Professional | 52 · Reduced service | $537.03 | $537.03 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | 53 · Discontinued | $213.80 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $218.78 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $707.95 Typical High $1,584.89 | Professional | 51 · Multiple procedures | $512.86 | $707.95 | $1,584.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $288.40 Typical High $630.96 | Professional | 80 · Assistant surgeon | $204.17 | $288.40 | $630.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $199.53 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $144.54 | $199.53 | $436.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $199.53 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $199.53 | $436.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $199.53 Typical High $436.52 | Professional | AS · PA/NP assist | $144.54 | $199.53 | $436.52 |
Where North Carolina sits
The same service costs 9.9 times more in Alabama 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
AL $18,241MD $1,851
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.