How much rates vary
Facilitymedian $1,445 · 10th to 90th $692 to $5,248Professionalmedian $1,047 · 10th to 90th $741 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 $707.95 Median $1,000.00 Typical High $8,317.64 | Facility | None | $707.95 | $1,000.00 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | None | $707.95 | $707.95 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,174.90 | Professional | None | $707.95 | $707.95 | $1,174.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $4,073.80 | Facility | None | $1,023.29 | $1,584.89 | $4,073.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,089.30 | Professional | None | $977.24 | $1,288.25 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,548.82 Typical High $2,187.76 | Facility | None | $645.65 | $1,548.82 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,778.28 | Professional | None | $758.58 | $794.33 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,148.15 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $891.25 Typical High $2,089.30 | Facility | None | $602.56 | $891.25 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,174.90 | Professional | None | $812.83 | $891.25 | $1,174.90 |
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 $616.60 Median $851.14 Typical High $1,778.28 | Professional | None | $616.60 | $851.14 | $1,778.28 |
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 $354.81 Median $354.81 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $602.56 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $446.68 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $295.12 | $446.68 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $446.68 Typical High $870.96 | Professional | 51 · Multiple procedures | $398.11 | $446.68 | $870.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $177.83 Typical High $346.74 | Professional | 80 · Assistant surgeon | $162.18 | $177.83 | $346.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $114.82 Median $125.89 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $114.82 | $125.89 | $239.88 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $114.82 Median $125.89 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $114.82 | $125.89 | $239.88 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $125.89 Typical High $239.88 | Professional | AS · PA/NP assist | $114.82 | $125.89 | $239.88 |
Where North Carolina sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.