How much rates vary
Facilitymedian $174 · 10th to 90th $98 to $794Professionalmedian $229 · 10th to 90th $126 to $447
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 $173.78 Typical High $7,413.10 | Facility | None | $107.15 | $173.78 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $194.98 | Professional | None | $107.15 | $173.78 | $194.98 |
BCBS North Carolina Setting Facility Modifier None Typical Low $97.72 Median $144.54 Typical High $194.98 | Facility | None | $97.72 | $144.54 | $194.98 |
BCBS North Carolina Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $457.09 | Professional | None | $151.36 | $257.04 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $190.55 Typical High $309.03 | Facility | None | $56.23 | $190.55 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $281.84 | Professional | None | $117.49 | $158.49 | $281.84 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $416.87 | Professional | None | $223.87 | $223.87 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $120.23 Median $186.21 Typical High $309.03 | Facility | None | $120.23 | $186.21 | $309.03 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $208.93 | Professional | None | $144.54 | $181.97 | $208.93 |
Oscar Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | None | $144.54 | $144.54 | $151.36 |
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 $104.71 Median $154.88 Typical High $257.04 | Professional | None | $104.71 | $154.88 | $257.04 |
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 $81.28 Typical High $91.20 | Professional | 52 · Reduced service | $53.70 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $32.36 Typical High $36.31 | Professional | 53 · Discontinued | $21.38 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $123.03 Typical High $134.90 | Professional | 54 · Surgery only | $79.43 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $24.55 Typical High $27.54 | Professional | 55 · Aftercare only | $15.85 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.22 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $114.82 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $74.13 | $114.82 | $125.89 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $58.88 Median $93.33 Typical High $154.88 | Facility | 51 · Multiple procedures | $58.88 | $93.33 | $154.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $91.20 Typical High $104.71 | Professional | 51 · Multiple procedures | $72.44 | $91.20 | $104.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $36.31 Typical High $42.66 | Professional | 80 · Assistant surgeon | $28.84 | $36.31 | $42.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $25.12 Typical High $30.20 | Professional | 81 · Minimal assistant surgeon | $19.95 | $25.12 | $30.20 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $25.12 Typical High $30.20 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $25.12 | $30.20 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $19.95 Median $25.12 Typical High $30.20 | Professional | AS · PA/NP assist | $19.95 | $25.12 | $30.20 |
Where North Carolina sits
The same service costs 3.5 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· 13th of 51
$229
AK $437NJ $126
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.