How much rates vary
Facilitymedian $363 · 10th to 90th $120 to $1,349Professionalmedian $219 · 10th to 90th $148 to $398
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 $123.03 Median $147.91 Typical High $7,413.10 | Facility | None | $123.03 | $147.91 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $173.78 | Professional | None | $123.03 | $147.91 | $173.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,659.59 | Facility | None | $831.76 | $1,230.27 | $1,659.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $426.58 | Professional | None | $173.78 | $251.19 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $1,318.26 | Facility | None | $181.97 | $295.12 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $389.05 | Professional | None | $151.36 | $165.96 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $346.74 | Professional | None | $229.09 | $229.09 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $389.05 Typical High $741.31 | Facility | None | $169.82 | $389.05 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $251.19 | Professional | None | $158.49 | $186.21 | $251.19 |
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 $117.49 Median $154.88 Typical High $338.84 | Professional | None | $117.49 | $154.88 | $338.84 |
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 $61.66 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $61.66 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $24.55 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $109.65 Typical High $114.82 | Professional | 54 · Surgery only | $93.33 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $23.44 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $102.33 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $87.10 | $102.33 | $107.15 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $93.33 Median $208.93 Typical High $371.54 | Facility | 51 · Multiple procedures | $93.33 | $208.93 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $93.33 Typical High $190.55 | Professional | 51 · Multiple procedures | $77.62 | $93.33 | $190.55 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $37.15 Typical High $72.44 | Professional | 80 · Assistant surgeon | $31.62 | $37.15 | $72.44 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $21.88 Median $26.30 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $21.88 | $26.30 | $51.29 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $21.88 Median $26.30 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $21.88 | $26.30 | $51.29 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $26.30 Typical High $51.29 | Professional | AS · PA/NP assist | $21.88 | $26.30 | $51.29 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 13th of 51
$224
AK $513DE $135
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.