How much rates vary
Facilitymedian $2,399 · 10th to 90th $575 to $6,918Professionalmedian $741 · 10th to 90th $457 to $1,230
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 $426.58 Median $501.19 Typical High $8,511.38 | Facility | None | $426.58 | $501.19 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $741.31 | Professional | None | $426.58 | $426.58 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $602.56 | Professional | None | $416.87 | $602.56 | $602.56 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,778.28 Median $2,818.38 Typical High $7,079.46 | Facility | None | $1,778.28 | $2,818.38 | $7,079.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $602.56 Median $912.01 Typical High $1,288.25 | Professional | None | $602.56 | $912.01 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $3,467.37 | Facility | None | $794.33 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $1,148.15 | Professional | None | $489.78 | $602.56 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $1,479.11 Typical High $2,754.23 | Facility | None | $707.95 | $1,479.11 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $954.99 | Professional | None | $512.86 | $630.96 | $954.99 |
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 $426.58 Median $549.54 Typical High $1,096.48 | Professional | None | $426.58 | $549.54 | $1,096.48 |
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 $213.80 Median $213.80 Typical High $275.42 | Professional | 52 · Reduced service | $213.80 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $389.05 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,096.48 Median $2,238.72 Typical High $5,370.32 | Facility | 50 · Both sides | $1,096.48 | $2,238.72 | $5,370.32 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $741.31 Typical High $1,778.28 | Facility | 51 · Multiple procedures | $363.08 | $741.31 | $1,778.28 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $954.99 Typical High $1,862.09 | Professional | 50 · Both sides | $758.58 | $954.99 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $316.23 Typical High $616.60 | Professional | 51 · Multiple procedures | $257.04 | $316.23 | $616.60 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $125.89 Typical High $251.19 | Professional | 80 · Assistant surgeon | $102.33 | $125.89 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $89.13 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $70.79 | $89.13 | $173.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $89.13 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $89.13 | $173.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $89.13 Typical High $173.78 | Professional | AS · PA/NP assist | $70.79 | $89.13 | $173.78 |
Where North Carolina sits
The same service costs 5.5 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 $7,406MT $1,352
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.