How much rates vary
Facilitymedian $1,950 · 10th to 90th $741 to $5,754Professionalmedian $955 · 10th to 90th $562 to $1,380
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 $575.44 Median $776.25 Typical High $10,000.00 | Facility | None | $575.44 | $776.25 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $1,000.00 | Professional | None | $524.81 | $575.44 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $4,466.84 | Facility | None | $1,122.02 | $1,737.80 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,445.44 | Professional | None | $691.83 | $977.24 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,818.38 Typical High $3,467.37 | Facility | None | $912.01 | $2,818.38 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,412.54 | Professional | None | $562.34 | $707.95 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,630.27 | Facility | None | $831.76 | $1,148.15 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,047.13 | Professional | None | $630.96 | $724.44 | $1,047.13 |
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 $501.19 Median $724.44 Typical High $1,445.44 | Professional | None | $501.19 | $724.44 | $1,445.44 |
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 $288.40 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $446.68 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $676.08 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $416.87 | $676.08 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $363.08 Typical High $776.25 | Professional | 51 · Multiple procedures | $316.23 | $363.08 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $144.54 Typical High $309.03 | Professional | 80 · Assistant surgeon | $125.89 | $144.54 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $87.10 Median $100.00 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $87.10 | $100.00 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $87.10 Median $100.00 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $87.10 | $100.00 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $100.00 Typical High $218.78 | Professional | AS · PA/NP assist | $87.10 | $100.00 | $218.78 |
Where North Carolina sits
The same service costs 3.6 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 $6,446MT $1,806
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.