How much rates vary
Facilitymedian $105 · 10th to 90th $51 to $891Professionalmedian $447 · 10th to 90th $339 to $1,096
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 $338.84 Median $457.09 Typical High $5,248.07 | Facility | None | $338.84 | $457.09 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $457.09 | Professional | None | $338.84 | $426.58 | $457.09 |
BCBS North Carolina Setting Facility Modifier None Typical Low $47.86 Median $69.18 Typical High $93.33 | Facility | None | $47.86 | $69.18 | $93.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $1,122.02 | Professional | None | $338.84 | $446.68 | $1,122.02 |
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 $363.08 Median $436.52 Typical High $1,023.29 | Professional | None | $363.08 | $436.52 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $602.56 | Professional | None | $426.58 | $426.58 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $43.65 Median $69.18 Typical High $549.54 | Facility | None | $43.65 | $69.18 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $575.44 | Professional | None | $302.00 | $562.34 | $575.44 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $954.99 | Professional | None | $295.12 | $436.52 | $954.99 |
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 $169.82 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $169.82 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $67.61 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $257.04 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $51.29 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $239.88 | $281.84 | $323.59 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $288.40 Typical High $389.05 | Professional | 51 · Multiple procedures | $151.36 | $288.40 | $389.05 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $114.82 Typical High $158.49 | Professional | 80 · Assistant surgeon | $60.26 | $114.82 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $41.69 Median $79.43 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $41.69 | $79.43 | $109.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $41.69 Median $79.43 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $41.69 | $79.43 | $109.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $79.43 Typical High $109.65 | Professional | AS · PA/NP assist | $41.69 | $79.43 | $109.65 |
Where North Carolina sits
The same service costs 4.7 times more in Alaska than in Texas. 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· 29th of 51
$447
AK $1,445TX $309
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.