How much rates vary
Facilitymedian $417 · 10th to 90th $251 to $1,862Professionalmedian $479 · 10th to 90th $288 to $851
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 $251.19 Median $363.08 Typical High $4,265.80 | Facility | None | $251.19 | $363.08 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $524.81 | Professional | None | $251.19 | $363.08 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $436.52 | Professional | None | $107.15 | $112.20 | $436.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $234.42 Median $363.08 Typical High $933.25 | Facility | None | $234.42 | $363.08 | $933.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $870.96 | Professional | None | $338.84 | $512.86 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $467.74 Typical High $676.08 | Facility | None | $100.00 | $467.74 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $776.25 | Professional | None | $288.40 | $363.08 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $870.96 | Professional | None | $501.19 | $501.19 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $407.38 Typical High $588.84 | Facility | None | $281.84 | $407.38 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $562.34 | Professional | None | $398.11 | $398.11 | $562.34 |
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 $239.88 Median $354.81 Typical High $724.44 | Professional | None | $239.88 | $354.81 | $724.44 |
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 $125.89 Median $173.78 Typical High $181.97 | Professional | 52 · Reduced service | $125.89 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $69.18 Typical High $72.44 | Professional | 53 · Discontinued | $50.12 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $52.48 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $34.67 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.12 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $239.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $177.83 | $239.88 | $257.04 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $141.25 Median $204.17 Typical High $316.23 | Facility | 51 · Multiple procedures | $141.25 | $204.17 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $199.53 Typical High $436.52 | Professional | 51 · Multiple procedures | $199.53 | $199.53 | $436.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $79.43 Typical High $173.78 | Professional | 80 · Assistant surgeon | $79.43 | $79.43 | $173.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $56.23 Median $56.23 Typical High $123.03 | Professional | 81 · Minimal assistant surgeon | $56.23 | $56.23 | $123.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $56.23 Median $56.23 Typical High $123.03 | Professional | 82 · Assistant surgeon, no resident | $56.23 | $56.23 | $123.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $56.23 Typical High $123.03 | Professional | AS · PA/NP assist | $56.23 | $56.23 | $123.03 |
Where North Carolina sits
The same service costs 4.5 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· 11th of 51
$479
AK $1,072TX $240
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.