How much rates vary
Facilitymedian $26,915 · 10th to 90th $871 to $45,709Professionalmedian $1,288 · 10th to 90th $537 to $2,344
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 $575.44 Median $1,584.89 Typical High $10,964.78 | Facility | None | $575.44 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $1,584.89 | Professional | None | $389.05 | $575.44 | $1,584.89 |
BCBS North Carolina Setting Facility Modifier None Typical Low $15,488.17 Median $24,547.09 Typical High $38,904.51 | Facility | None | $15,488.17 | $24,547.09 | $38,904.51 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,778.28 Typical High $2,398.83 | Professional | None | $891.25 | $1,778.28 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $29,512.09 Typical High $41,686.94 | Facility | None | $602.56 | $29,512.09 | $41,686.94 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $26,915.35 Typical High $56,234.13 | Facility | None | $616.60 | $26,915.35 | $56,234.13 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $1,047.13 | Professional | None | $331.13 | $467.74 | $1,047.13 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $28,183.83 Typical High $74,131.02 | Facility | None | $2,344.23 | $28,183.83 | $74,131.02 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,698.24 | Professional | None | $794.33 | $1,122.02 | $1,698.24 |
10 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 $194.98 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $194.98 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $77.62 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $58.88 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $38.90 | $57.54 | $57.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $234.42 Typical High $630.96 | Professional | 51 · Multiple procedures | $165.96 | $234.42 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $93.33 Typical High $251.19 | Professional | 80 · Assistant surgeon | $66.07 | $93.33 | $251.19 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $45.71 Median $66.07 Typical High $173.78 | Professional | 81 · Minimal assistant surgeon | $45.71 | $66.07 | $173.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $45.71 Median $66.07 Typical High $173.78 | Professional | 82 · Assistant surgeon, no resident | $45.71 | $66.07 | $173.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $66.07 Typical High $173.78 | Professional | AS · PA/NP assist | $45.71 | $66.07 | $173.78 |
Where North Carolina sits
The same service costs 50.1 times more in Arkansas than in New York. 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.
North Carolina· 26th of 51
$1,778
AR $19,498NY $389
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.