How much rates vary
Facilitymedian $339 · 10th to 90th $110 to $1,000Professionalmedian $389 · 10th to 90th $245 to $851
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 $190.55 Median $275.42 Typical High $7,585.78 | Facility | None | $190.55 | $275.42 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $331.13 | Professional | None | $190.55 | $275.42 | $331.13 |
BCBS North Carolina Setting Facility Modifier None Typical Low $251.19 Median $389.05 Typical High $1,000.00 | Facility | None | $251.19 | $389.05 | $1,000.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $912.01 | Professional | None | $295.12 | $489.78 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $758.58 | Facility | None | $223.87 | $363.08 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $660.69 | Professional | None | $245.47 | $331.13 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $724.44 | Facility | None | $275.42 | $389.05 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $489.78 | Professional | None | $263.03 | $380.19 | $489.78 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $1,096.48 | Facility | None | $77.62 | $165.96 | $1,096.48 |
United Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $691.83 | Professional | None | $208.93 | $323.59 | $691.83 |
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 $95.50 Median $138.04 Typical High $151.36 | Professional | 52 · Reduced service | $95.50 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $54.95 Typical High $60.26 | Professional | 53 · Discontinued | $38.02 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $144.54 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $40.74 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.05 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $134.90 | $190.55 | $213.80 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $154.88 Median $275.42 Typical High $363.08 | Facility | 51 · Multiple procedures | $154.88 | $275.42 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $190.55 Typical High $416.87 | Professional | 51 · Multiple procedures | $131.83 | $190.55 | $416.87 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $75.86 Typical High $165.96 | Professional | 80 · Assistant surgeon | $52.48 | $75.86 | $165.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $53.70 Typical High $117.49 | Professional | 81 · Minimal assistant surgeon | $36.31 | $53.70 | $117.49 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $53.70 Typical High $117.49 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $53.70 | $117.49 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $53.70 Typical High $117.49 | Professional | AS · PA/NP assist | $36.31 | $53.70 | $117.49 |
Where North Carolina sits
The same service costs 3.7 times more in Wisconsin 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· 16th of 51
$389
WI $891TX $240
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.