How much rates vary
Facilitymedian $1,995 · 10th to 90th $617 to $7,413Professionalmedian $562 · 10th to 90th $363 to $1,096
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 $407.38 Median $1,148.15 Typical High $7,943.28 | Facility | None | $407.38 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $1,148.15 | Professional | None | $407.38 | $407.38 | $1,148.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $2,344.23 | Facility | None | $1,148.15 | $1,698.24 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $363.08 Median $724.44 Typical High $1,148.15 | Professional | None | $363.08 | $724.44 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,890.45 Typical High $5,754.40 | Facility | None | $602.56 | $3,890.45 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $977.24 | Professional | None | $407.38 | $562.34 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $977.24 Typical High $4,677.35 | Facility | None | $512.86 | $977.24 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $660.69 | Professional | None | $380.19 | $467.74 | $660.69 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $1,096.48 | Professional | None | $389.05 | $524.81 | $1,096.48 |
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 $199.53 Median $199.53 Typical High $263.03 | Professional | 52 · Reduced service | $199.53 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | 53 · Discontinued | $81.28 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | 54 · Surgery only | $302.00 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $371.54 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $257.04 Median $512.86 Typical High $3,715.35 | Facility | 51 · Multiple procedures | $257.04 | $512.86 | $3,715.35 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $234.42 Typical High $575.44 | Professional | 51 · Multiple procedures | $190.55 | $234.42 | $575.44 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $93.33 Typical High $229.09 | Professional | 80 · Assistant surgeon | $77.62 | $93.33 | $229.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $53.70 Median $66.07 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $53.70 | $66.07 | $158.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $53.70 Median $66.07 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $53.70 | $66.07 | $158.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $66.07 Typical High $158.49 | Professional | AS · PA/NP assist | $53.70 | $66.07 | $158.49 |
Where North Carolina sits
The same service costs 5.4 times more in Alaska than in New York. 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· 27th of 51
$724
AK $2,239NY $417
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.