How much rates vary
Facilitymedian $468 · 10th to 90th $45 to $3,311Professionalmedian $275 · 10th to 90th $138 to $525
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 $109.65 Median $181.97 Typical High $1,584.89 | Facility | None | $109.65 | $181.97 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $223.87 | Professional | None | $109.65 | $181.97 | $223.87 |
BCBS North Carolina Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $69.18 | Facility | None | $35.48 | $51.29 | $69.18 |
BCBS North Carolina Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $575.44 | Professional | None | $181.97 | $309.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $186.21 | Facility | None | $50.12 | $50.12 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $380.19 | Professional | None | $138.04 | $204.17 | $380.19 |
Medcost Setting Facility Modifier None Typical Low $30.20 Median $426.58 Typical High $724.44 | Facility | None | $30.20 | $426.58 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $323.59 | Professional | None | $169.82 | $245.47 | $323.59 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $426.58 | Professional | None | $117.49 | $204.17 | $426.58 |
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 $54.95 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $54.95 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $39.81 | Professional | 53 · Discontinued | $21.88 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $128.82 Typical High $147.91 | Professional | 54 · Surgery only | $81.28 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $25.70 Typical High $29.51 | Professional | 55 · Aftercare only | $16.22 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.96 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $120.23 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $75.86 | $120.23 | $138.04 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $15.14 Median $363.08 Typical High $363.08 | Facility | 51 · Multiple procedures | $15.14 | $363.08 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $123.03 Typical High $275.42 | Professional | 51 · Multiple procedures | $85.11 | $123.03 | $275.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $33.88 Median $48.98 Typical High $109.65 | Professional | 80 · Assistant surgeon | $33.88 | $48.98 | $109.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $23.99 Median $34.67 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $23.99 | $34.67 | $75.86 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $23.99 Median $34.67 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $23.99 | $34.67 | $75.86 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $23.99 Median $34.67 Typical High $75.86 | Professional | AS · PA/NP assist | $23.99 | $34.67 | $75.86 |
Where North Carolina sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 15th of 51
$275
WI $589HI $155
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.