How much rates vary
Facilitymedian $1,660 · 10th to 90th $676 to $4,571Professionalmedian $550 · 10th to 90th $302 to $776
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 $281.84 Median $389.05 Typical High $8,511.38 | Facility | None | $281.84 | $389.05 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $489.78 | Professional | None | $281.84 | $281.84 | $489.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,412.54 | $2,089.30 | $2,818.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $794.33 | Professional | None | $389.05 | $562.34 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,659.59 Typical High $2,570.40 | Facility | None | $794.33 | $1,659.59 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $758.58 | Professional | None | $323.59 | $407.38 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,174.90 Typical High $1,412.54 | Facility | None | $676.08 | $1,174.90 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $645.65 | Professional | None | $338.84 | $446.68 | $645.65 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $707.95 | Professional | None | $281.84 | $363.08 | $707.95 |
12 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 $141.25 Median $141.25 Typical High $173.78 | Professional | 52 · Reduced service | $141.25 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $69.18 | Professional | 53 · Discontinued | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $245.47 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $588.84 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $363.08 | $588.84 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $234.42 Typical High $407.38 | Professional | 51 · Multiple procedures | $190.55 | $234.42 | $407.38 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $93.33 Typical High $165.96 | Professional | 80 · Assistant surgeon | $75.86 | $93.33 | $165.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $53.70 Median $66.07 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $53.70 | $66.07 | $114.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $53.70 Median $66.07 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $53.70 | $66.07 | $114.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $66.07 Typical High $114.82 | Professional | AS · PA/NP assist | $53.70 | $66.07 | $114.82 |
Where North Carolina sits
The same service costs 6.6 times more in Oklahoma 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
OK $6,126MT $925
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.