How much rates vary
Facilitymedian $3,890 · 10th to 90th $741 to $11,220Professionalmedian $891 · 10th to 90th $575 to $1,585
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 $562.34 Median $776.25 Typical High $11,481.54 | Facility | None | $562.34 | $776.25 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $891.25 | Professional | None | $562.34 | $562.34 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $691.83 Typical High $954.99 | Professional | None | $93.33 | $691.83 | $954.99 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,630.27 Median $3,548.13 Typical High $11,220.18 | Facility | None | $2,630.27 | $3,548.13 | $11,220.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,621.81 | Professional | None | $691.83 | $1,023.29 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $4,168.69 Typical High $6,025.60 | Facility | None | $1,258.93 | $4,168.69 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $1,096.48 | Professional | None | $562.34 | $575.44 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,318.26 | Professional | None | $870.96 | $870.96 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $4,168.69 | Facility | None | $1,096.48 | $1,995.26 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $891.25 | Professional | None | $524.81 | $691.83 | $891.25 |
Oscar Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | None | $602.56 | $602.56 | $630.96 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,466.84 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,466.84 | $17,782.79 |
United Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $1,047.13 | Professional | None | $467.74 | $562.34 | $1,047.13 |
14 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 $275.42 Median $275.42 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $457.09 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $3,235.94 Typical High $8,511.38 | Facility | 50 · Both sides | $1,778.28 | $3,235.94 | $8,511.38 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $588.84 Median $1,071.52 Typical High $2,818.38 | Facility | 51 · Multiple procedures | $588.84 | $1,071.52 | $2,818.38 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,096.48 Typical High $1,445.44 | Professional | 50 · Both sides | $794.33 | $1,096.48 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $263.03 Median $371.54 Typical High $478.63 | Professional | 51 · Multiple procedures | $263.03 | $371.54 | $478.63 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $147.91 Typical High $190.55 | Professional | 80 · Assistant surgeon | $107.15 | $147.91 | $190.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $74.13 Median $102.33 Typical High $134.90 | Professional | 81 · Minimal assistant surgeon | $74.13 | $102.33 | $134.90 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $74.13 Median $102.33 Typical High $134.90 | Professional | 82 · Assistant surgeon, no resident | $74.13 | $102.33 | $134.90 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $102.33 Typical High $134.90 | Professional | AS · PA/NP assist | $74.13 | $102.33 | $134.90 |
Where North Carolina sits
The same service costs 6.0 times more in Wisconsin than in Montana. 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
WI $11,096MT $1,846
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.