How much rates vary
Facilitymedian $708 · 10th to 90th $288 to $2,239Professionalmedian $282 · 10th to 90th $129 to $537
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 $107.15 Median $213.80 Typical High $5,248.07 | Facility | None | $107.15 | $213.80 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $288.40 | Professional | None | $107.15 | $213.80 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $154.88 Median $316.23 Typical High $562.34 | Professional | None | $154.88 | $316.23 | $562.34 |
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 $114.82 Median $194.98 Typical High $331.13 | Professional | None | $114.82 | $194.98 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $537.03 | Professional | None | $263.03 | $263.03 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $489.78 Typical High $977.24 | Facility | None | $213.80 | $489.78 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $245.47 | Professional | None | $204.17 | $239.88 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | None | $154.88 | $154.88 | $162.18 |
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 $104.71 Median $177.83 Typical High $288.40 | Professional | None | $104.71 | $177.83 | $288.40 |
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 $53.70 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $53.70 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $21.38 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $79.43 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $27.54 Typical High $33.11 | Professional | 55 · Aftercare only | $15.85 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.72 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $128.82 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $74.13 | $128.82 | $151.36 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $269.15 Typical High $758.58 | Facility | 51 · Multiple procedures | $186.21 | $269.15 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $120.23 Typical High $154.88 | Professional | 51 · Multiple procedures | $102.33 | $120.23 | $154.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $47.86 Typical High $50.12 | Professional | 80 · Assistant surgeon | $40.74 | $47.86 | $50.12 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $28.84 Median $33.88 Typical High $35.48 | Professional | 81 · Minimal assistant surgeon | $28.84 | $33.88 | $35.48 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $28.84 Median $33.88 Typical High $35.48 | Professional | 82 · Assistant surgeon, no resident | $28.84 | $33.88 | $35.48 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $28.84 Median $33.88 Typical High $35.48 | Professional | AS · PA/NP assist | $28.84 | $33.88 | $35.48 |
Where North Carolina sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 9th of 51
$288
AK $447DC $135
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.