How much rates vary
Facilitymedian $11,482 · 10th to 90th $417 to $28,184Professionalmedian $447 · 10th to 90th $275 to $891
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 $309.03 Median $1,000.00 Typical High $7,943.28 | Facility | None | $309.03 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $19,952.62 Median $27,542.29 Typical High $87,096.36 | Facility | None | $19,952.62 | $27,542.29 | $87,096.36 |
BCBS North Carolina Setting Professional Modifier None Typical Low $275.42 Median $489.78 Typical High $912.01 | Professional | None | $275.42 | $489.78 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $18,620.87 Typical High $26,915.35 | Facility | None | $457.09 | $18,620.87 | $26,915.35 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $776.25 | Professional | None | $331.13 | $346.74 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $724.44 | Professional | None | $501.19 | $501.19 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $26,302.68 | Facility | None | $371.54 | $776.25 | $26,302.68 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $512.86 | Professional | None | $354.81 | $389.05 | $512.86 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $10,232.93 Typical High $27,542.29 | Facility | None | $1,621.81 | $10,232.93 | $27,542.29 |
United Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $758.58 | Professional | None | $257.04 | $363.08 | $758.58 |
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 $154.88 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $61.66 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 54 · Surgery only | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $53.70 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $251.19 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $3,235.94 Typical High $14,125.38 | Facility | 51 · Multiple procedures | $186.21 | $3,235.94 | $14,125.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $194.98 Typical High $371.54 | Professional | 51 · Multiple procedures | $186.21 | $194.98 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $77.62 Typical High $147.91 | Professional | 80 · Assistant surgeon | $74.13 | $77.62 | $147.91 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $52.48 Median $54.95 Typical High $104.71 | Professional | 81 · Minimal assistant surgeon | $52.48 | $54.95 | $104.71 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $52.48 Median $54.95 Typical High $104.71 | Professional | 82 · Assistant surgeon, no resident | $52.48 | $54.95 | $104.71 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $54.95 Typical High $104.71 | Professional | AS · PA/NP assist | $52.48 | $54.95 | $104.71 |
Where North Carolina sits
The same service costs 29.1 times more in Alabama 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
AL $30,626MT $1,051
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.