How much rates vary
Facilitymedian $214 · 10th to 90th $100 to $741Professionalmedian $295 · 10th to 90th $174 to $646
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 $144.54 Median $229.09 Typical High $1,584.89 | Facility | None | $144.54 | $229.09 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $302.00 | Professional | None | $144.54 | $229.09 | $302.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $169.82 Median $263.03 Typical High $676.08 | Facility | None | $169.82 | $263.03 | $676.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $707.95 | Professional | None | $229.09 | $371.54 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $194.98 Typical High $316.23 | Facility | None | $56.23 | $194.98 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $524.81 | Professional | None | $173.78 | $239.88 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $275.42 Typical High $724.44 | Facility | None | $144.54 | $275.42 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $371.54 | Professional | None | $204.17 | $295.12 | $371.54 |
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 $165.96 Median $269.15 Typical High $537.03 | Professional | None | $165.96 | $269.15 | $537.03 |
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 $72.44 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $72.44 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $42.66 Typical High $50.12 | Professional | 53 · Discontinued | $28.84 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $109.65 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $21.88 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $102.33 | $151.36 | $177.83 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $70.79 Median $141.25 Typical High $363.08 | Facility | 51 · Multiple procedures | $70.79 | $141.25 | $363.08 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $144.54 Typical High $331.13 | Professional | 51 · Multiple procedures | $102.33 | $144.54 | $331.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $58.88 Typical High $131.83 | Professional | 80 · Assistant surgeon | $40.74 | $58.88 | $131.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.84 Median $40.74 Typical High $93.33 | Professional | 81 · Minimal assistant surgeon | $28.84 | $40.74 | $93.33 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.84 Median $40.74 Typical High $93.33 | Professional | 82 · Assistant surgeon, no resident | $28.84 | $40.74 | $93.33 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $40.74 Typical High $93.33 | Professional | AS · PA/NP assist | $28.84 | $40.74 | $93.33 |
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· 19th of 51
$288
WI $708TX $191
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.