How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $5,623Professionalmedian $676 · 10th to 90th $490 to $1,318
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 $446.68 Median $707.95 Typical High $7,943.28 | Facility | None | $446.68 | $707.95 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $794.33 | Professional | None | $446.68 | $446.68 | $794.33 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $4,570.88 | Facility | None | $1,148.15 | $1,737.80 | $4,570.88 |
BCBS North Carolina Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,348.96 | Professional | None | $602.56 | $891.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,290.87 Typical High $3,388.44 | Facility | None | $457.09 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,202.26 | Professional | None | $489.78 | $630.96 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $380.19 Median $812.83 Typical High $2,511.89 | Facility | None | $380.19 | $812.83 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $776.25 | Professional | None | $501.19 | $616.60 | $776.25 |
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 $446.68 Median $562.34 Typical High $1,122.02 | Professional | None | $446.68 | $562.34 | $1,122.02 |
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 $223.87 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $223.87 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | 53 · Discontinued | $89.13 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $338.84 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $389.05 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $478.63 Typical High $1,258.93 | Facility | 51 · Multiple procedures | $186.21 | $478.63 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $281.84 Median $309.03 Typical High $660.69 | Professional | 51 · Multiple procedures | $281.84 | $309.03 | $660.69 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $125.89 Typical High $263.03 | Professional | 80 · Assistant surgeon | $112.20 | $125.89 | $263.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $77.62 Median $87.10 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $77.62 | $87.10 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $77.62 Median $87.10 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $77.62 | $87.10 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $87.10 Typical High $181.97 | Professional | AS · PA/NP assist | $77.62 | $87.10 | $181.97 |
Where North Carolina sits
The same service costs 5.2 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 $7,535MT $1,449
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.