How much rates vary
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 $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,265.80 | Professional | None | $3,388.44 | $3,388.44 | $4,265.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $4,570.88 Median $7,585.78 Typical High $10,471.29 | Professional | None | $4,570.88 | $7,585.78 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $4,168.69 Median $5,011.87 Typical High $10,471.29 | Professional | None | $4,168.69 | $5,011.87 | $10,471.29 |
Medcost Setting Facility Modifier None Typical Low $3,388.44 Median $3,548.13 Typical High $5,370.32 | Facility | None | $3,388.44 | $3,548.13 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $5,495.41 | Professional | None | $3,235.94 | $4,570.88 | $5,495.41 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $5,370.32 Typical High $9,120.11 | Professional | None | $3,467.37 | $5,370.32 | $9,120.11 |
9 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 $1,698.24 Median $1,698.24 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $851.14 | Professional | 53 · Discontinued | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,511.89 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,511.89 | $2,511.89 | $3,235.94 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,344.23 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,344.23 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,584.89 Median $2,290.87 Typical High $5,011.87 | Professional | 51 · Multiple procedures | $1,584.89 | $2,290.87 | $5,011.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $645.65 Median $912.01 Typical High $1,995.26 | Professional | 80 · Assistant surgeon | $645.65 | $912.01 | $1,995.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $446.68 Median $645.65 Typical High $1,380.38 | Professional | 81 · Minimal assistant surgeon | $446.68 | $645.65 | $1,380.38 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $446.68 Median $645.65 Typical High $1,380.38 | Professional | 82 · Assistant surgeon, no resident | $446.68 | $645.65 | $1,380.38 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $446.68 Median $645.65 Typical High $1,380.38 | Professional | AS · PA/NP assist | $446.68 | $645.65 | $1,380.38 |
Where North Carolina sits
The same service costs 7.6 times more in Alaska than in Arkansas. 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· 16th of 51
$5,129
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.