How much rates vary
Facilitymedian $2,630 · 10th to 90th $513 to $8,128Professionalmedian $1,514 · 10th to 90th $776 to $2,291
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 $758.58 Median $1,000.00 Typical High $7,943.28 | Facility | None | $758.58 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $954.99 | Professional | None | $758.58 | $758.58 | $954.99 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,754.23 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,659.59 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $3,630.78 Typical High $5,370.32 | Facility | None | $457.09 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $2,041.74 | Professional | None | $776.25 | $1,023.29 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $1,258.93 Typical High $3,801.89 | Facility | None | $380.19 | $1,258.93 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,288.25 | Professional | None | $776.25 | $1,023.29 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,905.46 | Professional | None | $758.58 | $933.25 | $1,905.46 |
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 $380.19 Median $380.19 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $660.69 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $724.44 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $186.21 | $724.44 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $416.87 Median $524.81 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $416.87 | $524.81 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $213.80 Typical High $446.68 | Professional | 80 · Assistant surgeon | $165.96 | $213.80 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $147.91 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $114.82 | $147.91 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $147.91 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $147.91 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $147.91 Typical High $316.23 | Professional | AS · PA/NP assist | $114.82 | $147.91 | $316.23 |
Where North Carolina sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.