How much rates vary
Facilitymedian $3,162 · 10th to 90th $794 to $10,000Professionalmedian $1,380 · 10th to 90th $1,000 to $2,884
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 $977.24 Median $1,148.15 Typical High $7,943.28 | Facility | None | $977.24 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,479.11 | Professional | None | $977.24 | $977.24 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $1,778.28 Typical High $1,778.28 | Professional | None | $128.82 | $1,778.28 | $1,778.28 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $3,890.45 | Facility | None | $1,905.46 | $2,818.38 | $3,890.45 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,659.59 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $8,317.64 | Facility | None | $602.56 | $5,623.41 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,096.48 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,584.89 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $1,513.56 Typical High $4,365.16 | Facility | None | $549.54 | $1,513.56 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,258.93 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $2,398.83 | Professional | None | $851.14 | $1,174.90 | $2,398.83 |
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 $489.78 Median $489.78 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $831.76 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $758.58 Typical High $2,570.40 | Facility | 51 · Multiple procedures | $263.03 | $758.58 | $2,570.40 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $630.96 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $562.34 | $630.96 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $251.19 Typical High $467.74 | Professional | 80 · Assistant surgeon | $229.09 | $251.19 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $177.83 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $158.49 | $177.83 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $177.83 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $177.83 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $177.83 Typical High $331.13 | Professional | AS · PA/NP assist | $158.49 | $177.83 | $331.13 |
Where North Carolina sits
The same service costs 4.4 times more in Alaska than in Hawaii. 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 $10,992HI $2,489
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.