How much rates vary
Facilitymedian $4,266 · 10th to 90th $676 to $8,318Professionalmedian $468 · 10th to 90th $295 to $871
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 $436.52 Median $436.52 Typical High $7,943.28 | Facility | None | $436.52 | $436.52 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $524.81 | Professional | None | $407.38 | $436.52 | $524.81 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,981.07 Median $5,888.44 Typical High $8,317.64 | Facility | None | $3,981.07 | $5,888.44 | $8,317.64 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $1,096.48 | Professional | None | $295.12 | $512.86 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,365.16 Typical High $7,244.36 | Facility | None | $602.56 | $4,365.16 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $870.96 | Professional | None | $295.12 | $436.52 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $4,265.80 Typical High $8,912.51 | Facility | None | $436.52 | $4,265.80 | $8,912.51 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $724.44 | Professional | None | $323.59 | $338.84 | $724.44 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $1,096.48 | Professional | None | $275.42 | $446.68 | $1,096.48 |
10 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 $218.78 Median $218.78 Typical High $263.03 | Professional | 52 · Reduced service | $218.78 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $52.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $169.82 Typical High $645.65 | Professional | 51 · Multiple procedures | $162.18 | $169.82 | $645.65 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $67.61 Typical High $257.04 | Professional | 80 · Assistant surgeon | $64.57 | $67.61 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $45.71 Median $46.77 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $45.71 | $46.77 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $45.71 Median $46.77 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $45.71 | $46.77 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $46.77 Typical High $177.83 | Professional | AS · PA/NP assist | $45.71 | $46.77 | $177.83 |
Where North Carolina sits
The same service costs 5.2 times more in Alaska 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· 37th of 51
$513
AK $1,820KY $347
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.