How much rates vary
Facilitymedian $398 · 10th to 90th $110 to $1,230Professionalmedian $398 · 10th to 90th $245 to $832
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 $204.17 Median $302.00 Typical High $7,413.10 | Facility | None | $204.17 | $302.00 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $398.11 | Professional | None | $204.17 | $302.00 | $398.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $1,621.81 | Facility | None | $407.38 | $630.96 | $1,621.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $870.96 | Professional | None | $269.15 | $478.63 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $512.86 Typical High $1,318.26 | Facility | None | $346.74 | $512.86 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $691.83 | Professional | None | $251.19 | $323.59 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $380.19 Typical High $676.08 | Facility | None | $309.03 | $380.19 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $501.19 | Professional | None | $251.19 | $389.05 | $501.19 |
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 $229.09 Median $346.74 Typical High $707.95 | Professional | None | $229.09 | $346.74 | $707.95 |
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 $102.33 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $102.33 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $56.23 Typical High $67.61 | Professional | 53 · Discontinued | $40.74 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $213.80 Typical High $251.19 | Professional | 54 · Surgery only | $151.36 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $30.20 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.42 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $199.53 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $141.25 | $199.53 | $234.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $154.88 Median $194.98 Typical High $338.84 | Facility | 51 · Multiple procedures | $154.88 | $194.98 | $338.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $194.98 Typical High $436.52 | Professional | 51 · Multiple procedures | $125.89 | $194.98 | $436.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $77.62 Typical High $173.78 | Professional | 80 · Assistant surgeon | $51.29 | $77.62 | $173.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $35.48 Median $53.70 Typical High $120.23 | Professional | 81 · Minimal assistant surgeon | $35.48 | $53.70 | $120.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $35.48 Median $53.70 Typical High $120.23 | Professional | 82 · Assistant surgeon, no resident | $35.48 | $53.70 | $120.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $53.70 Typical High $120.23 | Professional | AS · PA/NP assist | $35.48 | $53.70 | $120.23 |
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
$398
WI $933TX $251
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.