How much rates vary
Facilitymedian $10,233 · 10th to 90th $603 to $33,884Professionalmedian $646 · 10th to 90th $437 to $1,148
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 $371.54 Median $933.25 Typical High $7,943.28 | Facility | None | $371.54 | $933.25 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $707.95 | Professional | None | $371.54 | $371.54 | $707.95 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,090.30 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,090.30 | $4,677.35 | $6,309.57 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,202.26 | Professional | None | $575.44 | $776.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $20,892.96 Typical High $30,902.95 | Facility | None | $602.56 | $20,892.96 | $30,902.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $1,000.00 | Professional | None | $467.74 | $602.56 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | None | $812.83 | $812.83 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $25,118.86 | Facility | None | $512.86 | $977.24 | $25,118.86 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $616.60 | Professional | None | $457.09 | $549.54 | $616.60 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $19,498.45 Typical High $45,708.82 | Facility | None | $2,238.72 | $19,498.45 | $45,708.82 |
United Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $933.25 | Professional | None | $323.59 | $501.19 | $933.25 |
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 $186.21 Median $186.21 Typical High $223.87 | Professional | 52 · Reduced service | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $316.23 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $7,079.46 Typical High $18,197.01 | Facility | 51 · Multiple procedures | $263.03 | $7,079.46 | $18,197.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $275.42 Typical High $457.09 | Professional | 51 · Multiple procedures | $251.19 | $275.42 | $457.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $109.65 Typical High $181.97 | Professional | 80 · Assistant surgeon | $100.00 | $109.65 | $181.97 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $77.62 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $70.79 | $77.62 | $128.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $77.62 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $77.62 | $128.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $77.62 Typical High $128.82 | Professional | AS · PA/NP assist | $70.79 | $77.62 | $128.82 |
Where North Carolina sits
The same service costs 29.4 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 $37,066MT $1,262
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.