How much rates vary
Facilitymedian $214 · 10th to 90th $100 to $891Professionalmedian $295 · 10th to 90th $126 to $589
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 $117.49 Median $263.03 Typical High $7,413.10 | Facility | None | $117.49 | $263.03 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $263.03 Typical High $323.59 | Professional | None | $117.49 | $263.03 | $323.59 |
BCBS North Carolina Setting Facility Modifier None Typical Low $169.82 Median $263.03 Typical High $676.08 | Facility | None | $169.82 | $263.03 | $676.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $645.65 | Professional | None | $177.83 | $323.59 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $194.98 Typical High $316.23 | Facility | None | $56.23 | $194.98 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $478.63 | Professional | None | $125.89 | $239.88 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $316.23 | Facility | None | $141.25 | $218.78 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $426.58 | Professional | None | $190.55 | $275.42 | $426.58 |
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 $114.82 Median $234.42 Typical High $457.09 | Professional | None | $114.82 | $234.42 | $457.09 |
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 $58.88 Median $95.50 Typical High $134.90 | Professional | 52 · Reduced service | $58.88 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $38.02 Typical High $53.70 | Professional | 53 · Discontinued | $23.44 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $141.25 Typical High $199.53 | Professional | 54 · Surgery only | $87.10 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $28.18 Typical High $39.81 | Professional | 55 · Aftercare only | $17.38 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $19.05 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.75 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $131.83 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $81.28 | $131.83 | $186.21 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $70.79 Median $109.65 Typical High $141.25 | Facility | 51 · Multiple procedures | $70.79 | $109.65 | $141.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $138.04 Typical High $346.74 | Professional | 51 · Multiple procedures | $95.50 | $138.04 | $346.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $54.95 Typical High $138.04 | Professional | 80 · Assistant surgeon | $38.02 | $54.95 | $138.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.30 Median $38.02 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $26.30 | $38.02 | $97.72 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.30 Median $38.02 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $26.30 | $38.02 | $97.72 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.30 Median $38.02 Typical High $97.72 | Professional | AS · PA/NP assist | $26.30 | $38.02 | $97.72 |
Where North Carolina sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 12th of 51
$282
WI $490KY $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.