How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,148 to $10,000Professionalmedian $1,950 · 10th to 90th $1,047 to $2,630
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 $1,023.29 Median $1,584.89 Typical High $11,481.54 | Facility | None | $1,023.29 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | None | $1,023.29 | $1,023.29 | $1,174.90 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,290.87 Median $3,801.89 Typical High $9,772.37 | Facility | None | $2,290.87 | $3,801.89 | $9,772.37 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,380.38 | $2,137.96 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $4,168.69 Typical High $6,025.60 | Facility | None | $1,258.93 | $4,168.69 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,691.53 | Professional | None | $1,148.15 | $1,348.96 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $4,265.80 | Facility | None | $1,148.15 | $1,995.26 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,318.26 | $1,698.24 |
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 $1,000.00 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,348.96 | $2,511.89 |
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 $501.19 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | 53 · Discontinued | $204.17 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $794.33 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $1,737.80 Median $3,019.95 Typical High $8,709.64 | Facility | 50 · Both sides | $1,737.80 | $3,019.95 | $8,709.64 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $588.84 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $588.84 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $1,995.26 Typical High $4,365.16 | Professional | 50 · Both sides | $1,778.28 | $1,995.26 | $4,365.16 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $660.69 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $602.56 | $660.69 | $1,445.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $263.03 Typical High $575.44 | Professional | 80 · Assistant surgeon | $239.88 | $263.03 | $575.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $186.21 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $165.96 | $186.21 | $407.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $186.21 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $186.21 | $407.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $186.21 Typical High $407.38 | Professional | AS · PA/NP assist | $165.96 | $186.21 | $407.38 |
Where North Carolina sits
The same service costs 3.6 times more in Alaska than in Montana. 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 $11,248MT $3,134
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.