How much rates vary
Facilitymedian $1,862 · 10th to 90th $794 to $5,623Professionalmedian $1,175 · 10th to 90th $676 to $1,950
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 $660.69 Median $1,000.00 Typical High $7,943.28 | Facility | None | $660.69 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | None | $660.69 | $660.69 | $891.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,238.72 | Facility | None | $1,122.02 | $1,659.59 | $2,238.72 |
BCBS North Carolina Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,949.84 | Professional | None | $933.25 | $1,479.11 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $4,168.69 | Facility | None | $602.56 | $2,511.89 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,778.28 | Professional | None | $831.76 | $954.99 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $3,630.78 | Facility | None | $794.33 | $1,905.46 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,096.48 | Professional | None | $691.83 | $933.25 | $1,096.48 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $9,120.11 | Facility | None | $851.14 | $1,698.24 | $9,120.11 |
United Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,659.59 | Professional | None | $660.69 | $891.25 | $1,659.59 |
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 $331.13 Median $331.13 Typical High $436.52 | Professional | 52 · Reduced service | $331.13 | $331.13 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $660.69 | Professional | 54 · Surgery only | $501.19 | $501.19 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $87.10 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $616.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $467.74 Typical High $954.99 | Professional | 51 · Multiple procedures | $436.52 | $467.74 | $954.99 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $186.21 Typical High $389.05 | Professional | 80 · Assistant surgeon | $173.78 | $186.21 | $389.05 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $131.83 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $123.03 | $131.83 | $269.15 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $131.83 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $131.83 | $269.15 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $131.83 Typical High $269.15 | Professional | AS · PA/NP assist | $123.03 | $131.83 | $269.15 |
Where North Carolina sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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 $7,369KY $1,773
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.