How much rates vary
Facilitymedian $2,042 · 10th to 90th $457 to $6,761Professionalmedian $525 · 10th to 90th $363 to $1,072
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 $354.81 Median $707.95 Typical High $7,943.28 | Facility | None | $354.81 | $707.95 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $630.96 | Professional | None | $354.81 | $354.81 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,511.89 | Facility | None | $1,258.93 | $1,862.09 | $2,511.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $1,071.52 | Professional | None | $426.58 | $707.95 | $1,071.52 |
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 $371.54 Median $489.78 Typical High $954.99 | Professional | None | $371.54 | $489.78 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $2,511.89 | Facility | None | $371.54 | $776.25 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $602.56 | Professional | None | $398.11 | $489.78 | $602.56 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $891.25 | Professional | None | $331.13 | $436.52 | $891.25 |
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 $177.83 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $177.83 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | 53 · Discontinued | $70.79 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $302.00 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $524.81 Typical High $1,819.70 | Facility | 51 · Multiple procedures | $186.21 | $524.81 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $245.47 Typical High $512.86 | Professional | 51 · Multiple procedures | $199.53 | $245.47 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $97.72 Typical High $208.93 | Professional | 80 · Assistant surgeon | $79.43 | $97.72 | $208.93 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $56.23 Median $69.18 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $56.23 | $69.18 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $56.23 Median $69.18 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $56.23 | $69.18 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $69.18 Typical High $144.54 | Professional | AS · PA/NP assist | $56.23 | $69.18 | $144.54 |
Where North Carolina sits
The same service costs 5.9 times more in Colorado 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
CO $6,847MT $1,164
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.