How much rates vary
Facilitymedian $1,698 · 10th to 90th $813 to $5,248Professionalmedian $977 · 10th to 90th $741 to $1,905
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 $758.58 Median $1,288.25 Typical High $8,317.64 | Facility | None | $758.58 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,096.48 | Professional | None | $758.58 | $758.58 | $1,096.48 |
BCBS North Carolina Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $2,454.71 | Facility | None | $954.99 | $1,548.82 | $2,454.71 |
BCBS North Carolina Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,905.46 | Professional | None | $741.31 | $977.24 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $3,019.95 | Facility | None | $602.56 | $1,995.26 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,659.59 | Professional | None | $794.33 | $954.99 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $2,630.27 | Facility | None | $912.01 | $1,412.54 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,071.52 | Professional | None | $741.31 | $1,071.52 | $1,071.52 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $9,120.11 | Facility | None | $851.14 | $1,698.24 | $9,120.11 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,659.59 | Professional | None | $724.44 | $1,000.00 | $1,659.59 |
13 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 $380.19 Median $380.19 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $380.19 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $194.98 | Professional | 53 · Discontinued | $151.36 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $741.31 | Professional | 54 · Surgery only | $562.34 | $562.34 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $691.83 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 50 · Both sides | $1,995.26 | $1,995.26 | $1,995.26 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,584.89 Typical High $1,584.89 | Professional | 50 · Both sides | $1,096.48 | $1,584.89 | $1,584.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $524.81 Typical High $524.81 | Professional | 51 · Multiple procedures | $371.54 | $524.81 | $524.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | 80 · Assistant surgeon | $147.91 | $213.80 | $213.80 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $102.33 | $147.91 | $147.91 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $147.91 | $147.91 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | AS · PA/NP assist | $102.33 | $147.91 | $147.91 |
Where North Carolina sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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
OK $7,181MS $1,948
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.