How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,288 to $13,490Professionalmedian $1,950 · 10th to 90th $1,175 to $2,818
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 $1,122.02 Median $1,288.25 Typical High $8,317.64 | Facility | None | $1,122.02 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,122.02 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,786.30 Median $7,413.10 Typical High $19,054.61 | Facility | None | $4,786.30 | $7,413.10 | $19,054.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,949.84 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,698.24 | $5,495.41 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,258.93 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,862.09 | $1,862.09 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $7,413.10 | Facility | None | $2,290.87 | $2,454.71 | $7,413.10 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,584.89 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,570.88 Typical High $19,054.61 | Facility | None | $1,380.38 | $4,570.88 | $19,054.61 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,630.27 | Professional | None | $954.99 | $1,348.96 | $2,630.27 |
14 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 $562.34 Median $562.34 Typical High $660.69 | Professional | 52 · Reduced service | $562.34 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 53 · Discontinued | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | 54 · Surgery only | $851.14 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $912.01 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $3,388.44 Median $3,630.78 Typical High $10,964.78 | Facility | 50 · Both sides | $3,388.44 | $3,630.78 | $10,964.78 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,230.27 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $1,148.15 | $1,230.27 | $3,715.35 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,818.38 Typical High $4,168.69 | Professional | 50 · Both sides | $2,089.30 | $2,818.38 | $4,168.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $954.99 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $707.95 | $954.99 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $380.19 Typical High $562.34 | Professional | 80 · Assistant surgeon | $281.84 | $380.19 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $263.03 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $194.98 | $263.03 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $263.03 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $263.03 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $263.03 Typical High $389.05 | Professional | AS · PA/NP assist | $194.98 | $263.03 | $389.05 |
Where North Carolina sits
The same service costs 5.0 times more in Colorado 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
CO $14,731KY $2,968
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.