How much rates vary
Facilitymedian $288 · 10th to 90th $85 to $2,089Professionalmedian $339 · 10th to 90th $158 to $813
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 $199.53 Median $323.59 Typical High $5,248.07 | Facility | None | $199.53 | $323.59 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $323.59 | Professional | None | $199.53 | $302.00 | $323.59 |
BCBS North Carolina Setting Facility Modifier None Typical Low $81.28 Median $120.23 Typical High $158.49 | Facility | None | $81.28 | $120.23 | $158.49 |
BCBS North Carolina Setting Professional Modifier None Typical Low $158.49 Median $346.74 Typical High $977.24 | Professional | None | $158.49 | $346.74 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $741.31 | Professional | None | $275.42 | $389.05 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | None | $512.86 | $512.86 | $588.84 |
Medcost Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $354.81 | Facility | None | $66.07 | $102.33 | $354.81 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $446.68 Typical High $501.19 | Professional | None | $199.53 | $446.68 | $501.19 |
United Setting Facility Modifier None Typical Low $295.12 Median $524.81 Typical High $2,818.38 | Facility | None | $295.12 | $524.81 | $2,818.38 |
United Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $691.83 | Professional | None | $213.80 | $338.84 | $691.83 |
11 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 $100.00 Median $141.25 Typical High $162.18 | Professional | 52 · Reduced service | $100.00 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $56.23 Typical High $64.57 | Professional | 53 · Discontinued | $39.81 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $208.93 Typical High $239.88 | Professional | 54 · Surgery only | $147.91 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $30.20 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $28.18 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $194.98 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $138.04 | $194.98 | $223.87 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $251.19 Typical High $288.40 | Professional | 51 · Multiple procedures | $100.00 | $251.19 | $288.40 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $100.00 Typical High $117.49 | Professional | 80 · Assistant surgeon | $39.81 | $100.00 | $117.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $27.54 Median $69.18 Typical High $81.28 | Professional | 81 · Minimal assistant surgeon | $27.54 | $69.18 | $81.28 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $27.54 Median $69.18 Typical High $81.28 | Professional | 82 · Assistant surgeon, no resident | $27.54 | $69.18 | $81.28 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $69.18 Typical High $81.28 | Professional | AS · PA/NP assist | $27.54 | $69.18 | $81.28 |
Where North Carolina sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 34th of 51
$339
AK $933KY $229
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.