How much rates vary
Facilitymedian $3,311 · 10th to 90th $912 to $6,918Professionalmedian $1,660 · 10th to 90th $1,175 to $2,951
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 $1,174.90 Median $1,288.25 Typical High $8,317.64 | Facility | None | $1,174.90 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,174.90 | $1,288.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,019.95 Median $4,466.84 Typical High $6,309.57 | Facility | None | $3,019.95 | $4,466.84 | $6,309.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,318.26 | $2,137.96 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,311.31 Typical High $5,495.41 | Facility | None | $602.56 | $3,311.31 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,513.56 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,174.90 | $3,311.31 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,479.11 | $1,905.46 |
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 $1,122.02 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,122.02 | $1,584.89 | $2,884.03 |
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 $588.84 Median $588.84 Typical High $645.65 | Professional | 52 · Reduced service | $588.84 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $977.24 | Professional | 54 · Surgery only | $870.96 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $741.31 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $562.34 | $741.31 | $1,659.59 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $295.12 Typical High $676.08 | Professional | 80 · Assistant surgeon | $223.87 | $295.12 | $676.08 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $208.93 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $154.88 | $208.93 | $467.74 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $208.93 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $208.93 | $467.74 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $208.93 Typical High $467.74 | Professional | AS · PA/NP assist | $154.88 | $208.93 | $467.74 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska 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
AK $10,675KY $2,405
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.