How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,047 to $9,772Professionalmedian $1,905 · 10th to 90th $1,349 to $3,715
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 $1,288.25 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,288.25 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,168.69 Median $6,165.95 Typical High $8,511.38 | Facility | None | $4,168.69 | $6,165.95 | $8,511.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,513.56 | $2,344.23 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,570.88 Typical High $7,585.78 | Facility | None | $602.56 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,479.11 | $1,862.09 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,348.96 Median $3,715.35 Typical High $12,022.64 | Facility | None | $1,348.96 | $3,715.35 | $12,022.64 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,584.89 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,318.26 | $1,862.09 | $3,548.13 |
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 $645.65 Median $645.65 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,258.93 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,174.90 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $851.14 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $616.60 | $851.14 | $1,905.46 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $338.84 Typical High $758.58 | Professional | 80 · Assistant surgeon | $251.19 | $338.84 | $758.58 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $239.88 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $173.78 | $239.88 | $524.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $239.88 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $239.88 | $524.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $239.88 Typical High $524.81 | Professional | AS · PA/NP assist | $173.78 | $239.88 | $524.81 |
Where North Carolina sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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 $18,462KY $2,797
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.