How much rates vary
Facilitymedian $1,514 · 10th to 90th $562 to $5,248Professionalmedian $562 · 10th to 90th $437 to $1,380
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 $436.52 Median $562.34 Typical High $7,943.28 | Facility | None | $436.52 | $562.34 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $933.25 | Professional | None | $436.52 | $562.34 | $933.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $4,265.80 | Facility | None | $1,071.52 | $1,698.24 | $4,265.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,412.54 | Professional | None | $446.68 | $562.34 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $2,187.76 | Facility | None | $645.65 | $1,778.28 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $977.24 | Professional | None | $371.54 | $489.78 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $851.14 Typical High $2,041.74 | Facility | None | $575.44 | $851.14 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $794.33 | Professional | None | $645.65 | $724.44 | $794.33 |
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 $426.58 Median $549.54 Typical High $1,071.52 | Professional | None | $426.58 | $549.54 | $1,071.52 |
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 $218.78 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $218.78 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $87.10 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $323.59 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $64.57 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $63.10 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $302.00 | $398.11 | $436.52 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $891.25 Median $1,445.44 Typical High $3,235.94 | Facility | 50 · Both sides | $891.25 | $1,445.44 | $3,235.94 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $295.12 Median $489.78 Typical High $1,071.52 | Facility | 51 · Multiple procedures | $295.12 | $489.78 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,096.48 Typical High $1,380.38 | Professional | 50 · Both sides | $1,023.29 | $1,096.48 | $1,380.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $363.08 Typical High $457.09 | Professional | 51 · Multiple procedures | $338.84 | $363.08 | $457.09 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $144.54 Typical High $181.97 | Professional | 80 · Assistant surgeon | $134.90 | $144.54 | $181.97 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $95.50 Median $102.33 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $95.50 | $102.33 | $128.82 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $102.33 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $102.33 | $128.82 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $102.33 Typical High $128.82 | Professional | AS · PA/NP assist | $95.50 | $102.33 | $128.82 |
Where North Carolina sits
The same service costs 4.0 times more in Oklahoma than in West Virginia. 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 $5,056WV $1,262
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.