How much rates vary
Facilitymedian $3,388 · 10th to 90th $832 to $10,000Professionalmedian $1,148 · 10th to 90th $759 to $2,042
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 $724.44 Median $1,000.00 Typical High $8,128.31 | Facility | None | $724.44 | $1,000.00 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,288.25 | Professional | None | $724.44 | $724.44 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $1,288.25 Typical High $1,479.11 | Professional | None | $537.03 | $1,288.25 | $1,479.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $10,715.19 | Facility | None | $2,511.89 | $3,467.37 | $10,715.19 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,412.54 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $5,888.44 | Facility | None | $912.01 | $4,073.80 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,905.46 | Professional | None | $870.96 | $1,023.29 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $4,570.88 | Facility | None | $831.76 | $2,089.30 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | None | $870.96 | $1,071.52 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,467.37 | $15,848.93 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,819.70 | Professional | None | $707.95 | $1,047.13 | $1,819.70 |
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 $363.08 Median $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $147.91 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $575.44 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,047.13 Typical High $3,311.31 | Facility | 51 · Multiple procedures | $416.87 | $1,047.13 | $3,311.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $691.83 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $467.74 | $691.83 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $275.42 Typical High $416.87 | Professional | 80 · Assistant surgeon | $186.21 | $275.42 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $194.98 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $131.83 | $194.98 | $295.12 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $194.98 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $194.98 | $295.12 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $194.98 Typical High $295.12 | Professional | AS · PA/NP assist | $131.83 | $194.98 | $295.12 |
Where North Carolina sits
The same service costs 4.5 times more in Alaska 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
AK $10,099MT $2,245
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.