How much rates vary
Facilitymedian $933 · 10th to 90th $501 to $3,311Professionalmedian $1,023 · 10th to 90th $550 to $1,862
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 $691.83 Typical High $7,585.78 | Facility | None | $575.44 | $691.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $758.58 | Professional | None | $575.44 | $691.83 | $758.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,630.78 | Facility | None | $912.01 | $1,445.44 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,862.09 | Professional | None | $691.83 | $1,047.13 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,096.48 Typical High $1,819.70 | Facility | None | $602.56 | $1,096.48 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,513.56 | Professional | None | $512.86 | $616.60 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,659.59 | Professional | None | $758.58 | $758.58 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $707.95 Typical High $1,288.25 | Facility | None | $331.13 | $707.95 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $1,096.48 | Professional | None | $416.87 | $794.33 | $1,096.48 |
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 $501.19 Median $660.69 Typical High $1,513.56 | Professional | None | $501.19 | $660.69 | $1,513.56 |
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 $288.40 Median $346.74 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $138.04 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $436.52 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $69.18 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $407.38 | $478.63 | $524.81 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $154.88 Median $331.13 Typical High $758.58 | Facility | 51 · Multiple procedures | $154.88 | $331.13 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $398.11 Typical High $831.76 | Professional | 51 · Multiple procedures | $208.93 | $398.11 | $831.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $158.49 Typical High $331.13 | Professional | 80 · Assistant surgeon | $83.18 | $158.49 | $331.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $112.20 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $57.54 | $112.20 | $234.42 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $112.20 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $112.20 | $234.42 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $112.20 Typical High $234.42 | Professional | AS · PA/NP assist | $57.54 | $112.20 | $234.42 |
Where North Carolina sits
The same service costs 5.6 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
$1,023
AK $2,399TX $427
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.