How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,175 to $8,318Professionalmedian $2,042 · 10th to 90th $1,259 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 $1,174.90 Median $1,445.44 Typical High $10,000.00 | Facility | None | $1,174.90 | $1,445.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,445.44 | $2,137.96 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,398.83 Median $3,548.13 Typical High $4,786.30 | Facility | None | $2,398.83 | $3,548.13 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $2,754.23 Typical High $4,168.69 | Professional | None | $1,258.93 | $2,754.23 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $6,025.60 | Facility | None | $912.01 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $3,467.37 | Professional | None | $1,412.54 | $1,698.24 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $4,897.79 | Facility | None | $831.76 | $1,995.26 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,819.70 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,698.24 | $3,311.31 |
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 $588.84 Median $724.44 Typical High $794.33 | Professional | 52 · Reduced service | $588.84 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $288.40 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $891.25 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $177.83 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $144.54 Typical High $158.49 | Professional | 56 · Pre-op care only | $117.49 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $831.76 | $1,000.00 | $1,096.48 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 51 · Multiple procedures | $457.09 | $457.09 | $457.09 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $416.87 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $912.01 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $724.44 | $912.01 | $2,089.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $363.08 Typical High $831.76 | Professional | 80 · Assistant surgeon | $288.40 | $363.08 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $251.19 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $204.17 | $251.19 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $251.19 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $251.19 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $251.19 Typical High $575.44 | Professional | AS · PA/NP assist | $204.17 | $251.19 | $575.44 |
Where North Carolina sits
The same service costs 3.2 times more in Alaska 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
AK $12,311KY $3,892
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.