How much rates vary
Facilitymedian $513 · 10th to 90th $275 to $3,162Professionalmedian $457 · 10th to 90th $240 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 $218.78 Median $346.74 Typical High $7,413.10 | Facility | None | $218.78 | $346.74 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $363.08 | Professional | None | $218.78 | $338.84 | $363.08 |
BCBS North Carolina Setting Facility Modifier None Typical Low $181.97 Median $275.42 Typical High $724.44 | Facility | None | $181.97 | $275.42 | $724.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $239.88 Median $501.19 Typical High $870.96 | Professional | None | $239.88 | $501.19 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $851.14 | Facility | None | $309.03 | $478.63 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $549.54 | Professional | None | $263.03 | $316.23 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $831.76 | Professional | None | $457.09 | $457.09 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $512.86 | Facility | None | $218.78 | $331.13 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $407.38 | Professional | None | $295.12 | $338.84 | $407.38 |
Oscar Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $316.23 | Professional | None | $295.12 | $295.12 | $316.23 |
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 $204.17 Median $302.00 Typical High $501.19 | Professional | None | $204.17 | $302.00 | $501.19 |
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 $107.15 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $107.15 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $63.10 Typical High $70.79 | Professional | 53 · Discontinued | $43.65 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $162.18 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $32.36 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $31.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $21.88 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $223.87 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $151.36 | $223.87 | $245.47 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $107.15 Median $165.96 Typical High $257.04 | Facility | 51 · Multiple procedures | $107.15 | $165.96 | $257.04 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $169.82 Typical High $213.80 | Professional | 51 · Multiple procedures | $147.91 | $169.82 | $213.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $72.44 Typical High $85.11 | Professional | 80 · Assistant surgeon | $58.88 | $72.44 | $85.11 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $41.69 Median $50.12 Typical High $60.26 | Professional | 81 · Minimal assistant surgeon | $41.69 | $50.12 | $60.26 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $41.69 Median $50.12 Typical High $60.26 | Professional | 82 · Assistant surgeon, no resident | $41.69 | $50.12 | $60.26 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $50.12 Typical High $60.26 | Professional | AS · PA/NP assist | $41.69 | $50.12 | $60.26 |
Where North Carolina sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 12th of 51
$457
AK $912NJ $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.