How much rates vary
Facilitymedian $2,692 · 10th to 90th $851 to $6,310Professionalmedian $933 · 10th to 90th $617 to $1,698
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 $707.95 Median $707.95 Typical High $7,943.28 | Facility | None | $707.95 | $707.95 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $933.25 | Professional | None | $707.95 | $707.95 | $933.25 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $4,466.84 | Facility | None | $2,137.96 | $3,162.28 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,737.80 | Professional | None | $776.25 | $1,096.48 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,344.23 Typical High $3,890.45 | Facility | None | $602.56 | $2,344.23 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $1,584.89 | Professional | None | $512.86 | $812.83 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $2,454.71 Typical High $5,128.61 | Facility | None | $812.83 | $2,454.71 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $1,174.90 | Professional | None | $512.86 | $707.95 | $1,174.90 |
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 $575.44 Median $831.76 Typical High $1,949.84 | Professional | None | $575.44 | $831.76 | $1,949.84 |
11 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 $354.81 Median $354.81 Typical High $457.09 | Professional | 52 · Reduced service | $354.81 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $524.81 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $645.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $346.74 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $257.04 | $346.74 | $1,000.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $141.25 Typical High $398.11 | Professional | 80 · Assistant surgeon | $102.33 | $141.25 | $398.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $97.72 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $70.79 | $97.72 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $97.72 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $97.72 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $97.72 Typical High $281.84 | Professional | AS · PA/NP assist | $70.79 | $97.72 | $281.84 |
Where North Carolina sits
The same service costs 6.8 times more in Oklahoma 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· 26th of 51
$1,096
OK $4,169KY $617
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.