How much rates vary
Facilitymedian $759 · 10th to 90th $372 to $2,291Professionalmedian $437 · 10th to 90th $245 to $759
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 $194.98 Median $263.03 Typical High $7,413.10 | Facility | None | $194.98 | $263.03 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $346.74 | Professional | None | $194.98 | $263.03 | $346.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $794.33 | Facility | None | $398.11 | $588.84 | $794.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $851.14 | Professional | None | $323.59 | $501.19 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,348.96 | Facility | None | $457.09 | $1,071.52 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $660.69 | Professional | None | $245.47 | $302.00 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $549.54 Typical High $1,513.56 | Facility | None | $309.03 | $549.54 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $467.74 | Professional | None | $251.19 | $363.08 | $467.74 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $645.65 | Professional | None | $208.93 | $309.03 | $645.65 |
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 $131.83 Typical High $144.54 | Professional | 52 · Reduced service | $95.50 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $52.48 Typical High $57.54 | Professional | 53 · Discontinued | $38.90 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $213.80 | Professional | 54 · Surgery only | $144.54 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $39.81 Typical High $42.66 | Professional | 55 · Aftercare only | $28.84 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.30 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.50 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $186.21 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $134.90 | $186.21 | $199.53 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $354.81 Typical High $758.58 | Facility | 51 · Multiple procedures | $186.21 | $354.81 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $181.97 Typical High $398.11 | Professional | 51 · Multiple procedures | $125.89 | $181.97 | $398.11 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $72.44 Typical High $158.49 | Professional | 80 · Assistant surgeon | $50.12 | $72.44 | $158.49 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $50.12 Typical High $112.20 | Professional | 81 · Minimal assistant surgeon | $35.48 | $50.12 | $112.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $50.12 Typical High $112.20 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $50.12 | $112.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $50.12 Typical High $112.20 | Professional | AS · PA/NP assist | $35.48 | $50.12 | $112.20 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 13th of 51
$447
AK $1,000UT $234
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.