How much rates vary
Facilitymedian $1,950 · 10th to 90th $525 to $6,310Professionalmedian $891 · 10th to 90th $646 to $1,995
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 $794.33 Median $794.33 Typical High $7,413.10 | Facility | None | $794.33 | $794.33 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,288.25 | Professional | None | $794.33 | $794.33 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $933.25 | Professional | None | $691.83 | $831.76 | $933.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $5,011.87 | Facility | None | $1,258.93 | $1,995.26 | $5,011.87 |
BCBS North Carolina Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $2,187.76 | Professional | None | $645.65 | $891.25 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,951.21 Typical High $4,365.16 | Facility | None | $457.09 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,513.56 | Professional | None | $616.60 | $758.58 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $389.05 Median $1,023.29 Typical High $3,388.44 | Facility | None | $389.05 | $1,023.29 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,047.13 | Professional | None | $776.25 | $891.25 | $1,047.13 |
Oscar Health Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $6,309.57 | Facility | None | $3,235.94 | $3,235.94 | $6,309.57 |
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 $776.25 Typical High $1,548.82 | Professional | None | $616.60 | $776.25 | $1,548.82 |
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 $398.11 Median $398.11 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $398.11 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $707.95 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $562.34 Median $1,548.82 Typical High $7,079.46 | Facility | 50 · Both sides | $562.34 | $1,548.82 | $7,079.46 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $190.55 Median $512.86 Typical High $2,344.23 | Facility | 51 · Multiple procedures | $190.55 | $512.86 | $2,344.23 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,348.96 Typical High $1,737.80 | Professional | 50 · Both sides | $1,148.15 | $1,348.96 | $1,737.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $446.68 Typical High $575.44 | Professional | 51 · Multiple procedures | $380.19 | $446.68 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $177.83 Typical High $234.42 | Professional | 80 · Assistant surgeon | $154.88 | $177.83 | $234.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $107.15 Median $125.89 Typical High $162.18 | Professional | 81 · Minimal assistant surgeon | $107.15 | $125.89 | $162.18 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $107.15 Median $125.89 Typical High $162.18 | Professional | 82 · Assistant surgeon, no resident | $107.15 | $125.89 | $162.18 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $125.89 Typical High $162.18 | Professional | AS · PA/NP assist | $107.15 | $125.89 | $162.18 |
Where North Carolina sits
The same service costs 5.4 times more in Alaska than in South Carolina. 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 $8,807SC $1,633
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.