How much rates vary
Facilitymedian $776 · 10th to 90th $407 to $8,318Professionalmedian $537 · 10th to 90th $316 to $955
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 $295.12 Median $457.09 Typical High $5,248.07 | Facility | None | $295.12 | $457.09 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $467.74 | Professional | None | $295.12 | $436.52 | $467.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $295.12 Median $457.09 Typical High $1,148.15 | Facility | None | $295.12 | $457.09 | $1,148.15 |
BCBS North Carolina Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $954.99 | Professional | None | $371.54 | $602.56 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $660.69 Typical High $1,047.13 | Facility | None | $467.74 | $660.69 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $707.95 | Professional | None | $269.15 | $338.84 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,096.48 | Professional | None | $467.74 | $467.74 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $741.31 | Facility | None | $302.00 | $478.63 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $478.63 | Professional | None | $263.03 | $436.52 | $478.63 |
Oscar Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $263.03 | Professional | None | $245.47 | $245.47 | $263.03 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $630.96 | Professional | None | $257.04 | $354.81 | $630.96 |
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 $144.54 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $144.54 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $58.88 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $218.78 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $43.65 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $29.51 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $281.84 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $204.17 | $281.84 | $316.23 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $151.36 Median $234.42 Typical High $371.54 | Facility | 51 · Multiple procedures | $151.36 | $234.42 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $218.78 Typical High $234.42 | Professional | 51 · Multiple procedures | $131.83 | $218.78 | $234.42 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $87.10 Typical High $89.13 | Professional | 80 · Assistant surgeon | $52.48 | $87.10 | $89.13 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $37.15 Median $61.66 Typical High $61.66 | Professional | 81 · Minimal assistant surgeon | $37.15 | $61.66 | $61.66 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $37.15 Median $61.66 Typical High $61.66 | Professional | 82 · Assistant surgeon, no resident | $37.15 | $61.66 | $61.66 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $61.66 Typical High $61.66 | Professional | AS · PA/NP assist | $37.15 | $61.66 | $61.66 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 15th of 51
$537
AK $1,259KY $295
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.