How much rates vary
Facilitymedian $603 · 10th to 90th $275 to $2,239Professionalmedian $724 · 10th to 90th $550 to $1,445
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 $537.03 Median $1,288.25 Typical High $8,317.64 | Facility | None | $537.03 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | None | $537.03 | $537.03 | $616.60 |
BCBS North Carolina Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $309.03 | Facility | None | $77.62 | $120.23 | $309.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,445.44 | Professional | None | $645.65 | $912.01 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $676.08 Typical High $1,995.26 | Facility | None | $467.74 | $676.08 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $1,202.26 | Professional | None | $562.34 | $602.56 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,258.93 | Professional | None | $870.96 | $870.96 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $588.84 Typical High $977.24 | Facility | None | $83.18 | $588.84 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $891.25 | Professional | None | $602.56 | $691.83 | $891.25 |
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 $446.68 Median $575.44 Typical High $1,318.26 | Professional | None | $446.68 | $575.44 | $1,318.26 |
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 $263.03 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $426.58 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $38.90 Median $288.40 Typical High $489.78 | Facility | 51 · Multiple procedures | $38.90 | $288.40 | $489.78 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $302.00 Median $346.74 Typical High $645.65 | Professional | 51 · Multiple procedures | $302.00 | $346.74 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $141.25 Typical High $257.04 | Professional | 80 · Assistant surgeon | $125.89 | $141.25 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $89.13 Median $97.72 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $89.13 | $97.72 | $181.97 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $89.13 Median $97.72 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $89.13 | $97.72 | $181.97 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $97.72 Typical High $181.97 | Professional | AS · PA/NP assist | $89.13 | $97.72 | $181.97 |
Where North Carolina sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 22nd of 51
$708
AK $2,239UT $355
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.