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 $1,862.09 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,862.09 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,862.09 | $1,862.09 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $5,623.41 | Professional | None | $2,137.96 | $3,467.37 | $5,623.41 |
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 $2,454.71 Median $2,754.23 Typical High $5,888.44 | Professional | None | $2,454.71 | $2,754.23 | $5,888.44 |
Medcost Setting Facility Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $2,951.21 | Facility | None | $1,862.09 | $1,905.46 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $2,951.21 | Professional | None | $1,737.80 | $2,691.53 | $2,951.21 |
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 $1,905.46 Median $3,019.95 Typical High $5,011.87 | Professional | None | $1,905.46 | $3,019.95 | $5,011.87 |
8 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 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,659.59 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $4,073.80 Typical High $8,128.31 | Professional | 50 · Both sides | $2,630.27 | $4,073.80 | $8,128.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $1,348.96 Typical High $2,691.53 | Professional | 51 · Multiple procedures | $870.96 | $1,348.96 | $2,691.53 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $549.54 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $346.74 | $549.54 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $380.19 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $245.47 | $380.19 | $758.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $380.19 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $380.19 | $758.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $380.19 Typical High $758.58 | Professional | AS · PA/NP assist | $245.47 | $380.19 | $758.58 |
Where North Carolina sits
The same service costs 5.1 times more in Alaska than in Texas. 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· 20th of 51
$2,754
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.