How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $6,761Professionalmedian $1,905 · 10th to 90th $1,202 to $3,236
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 $1,202.26 Median $1,202.26 Typical High $7,943.28 | Facility | None | $1,202.26 | $1,202.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,202.26 | $1,412.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,513.56 | $2,137.96 | $3,388.44 |
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 $1,122.02 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,230.27 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,698.24 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,778.28 | Facility | None | $724.44 | $724.44 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,230.27 | $1,479.11 |
Oscar Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $851.14 | Professional | None | $812.83 | $812.83 | $851.14 |
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 $1,023.29 Median $1,230.27 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,230.27 | $2,290.87 |
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 $602.56 Median $602.56 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 53 · Discontinued | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $616.60 Typical High $741.31 | Professional | 51 · Multiple procedures | $562.34 | $616.60 | $741.31 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $245.47 Typical High $295.12 | Professional | 80 · Assistant surgeon | $229.09 | $245.47 | $295.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $173.78 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $158.49 | $173.78 | $204.17 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $173.78 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $173.78 | $204.17 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $173.78 Typical High $204.17 | Professional | AS · PA/NP assist | $158.49 | $173.78 | $204.17 |
Where North Carolina sits
The same service costs 5.9 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 $10,682MD $1,821
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.