How much rates vary
Facilitymedian $1,318 · 10th to 90th $525 to $3,981Professionalmedian $851 · 10th to 90th $676 to $1,820
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 $691.83 Median $851.14 Typical High $7,585.78 | Facility | None | $691.83 | $851.14 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $851.14 | Professional | None | $691.83 | $741.31 | $851.14 |
BCBS North Carolina Setting Facility Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,715.35 | Facility | None | $933.25 | $1,445.44 | $3,715.35 |
BCBS North Carolina Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,862.09 | Professional | None | $707.95 | $870.96 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,951.21 | Facility | None | $602.56 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,862.09 | Professional | None | $724.44 | $812.83 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,000.00 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $1,071.52 Typical High $2,398.83 | Facility | None | $691.83 | $1,071.52 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,047.13 | Professional | None | $676.08 | $954.99 | $1,047.13 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,778.28 | Professional | None | $588.84 | $776.25 | $1,778.28 |
12 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 $346.74 Median $371.54 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $169.82 | Professional | 53 · Discontinued | $138.04 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $549.54 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $549.54 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $588.84 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $346.74 Median $537.03 Typical High $1,445.44 | Facility | 51 · Multiple procedures | $346.74 | $537.03 | $1,445.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $478.63 Typical High $691.83 | Professional | 51 · Multiple procedures | $331.13 | $478.63 | $691.83 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $190.55 Typical High $275.42 | Professional | 80 · Assistant surgeon | $134.90 | $190.55 | $275.42 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $93.33 Median $131.83 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $93.33 | $131.83 | $194.98 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $93.33 Median $131.83 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $93.33 | $131.83 | $194.98 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $131.83 Typical High $194.98 | Professional | AS · PA/NP assist | $93.33 | $131.83 | $194.98 |
Where North Carolina sits
The same service costs 4.9 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· 36th of 51
$851
AK $2,884TX $589
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.