How much rates vary
Facilitymedian $1,318 · 10th to 90th $407 to $3,890Professionalmedian $851 · 10th to 90th $447 to $1,349
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 $346.74 Median $537.03 Typical High $7,413.10 | Facility | None | $346.74 | $537.03 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $562.34 | Professional | None | $346.74 | $512.86 | $562.34 |
BCBS North Carolina Setting Facility Modifier None Typical Low $912.01 Median $1,445.44 Typical High $3,630.78 | Facility | None | $912.01 | $1,445.44 | $3,630.78 |
BCBS North Carolina Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $1,348.96 | Professional | None | $489.78 | $912.01 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,995.26 Typical High $2,951.21 | Facility | None | $457.09 | $1,995.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $831.76 | Professional | None | $389.05 | $512.86 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,288.25 | Professional | None | $707.95 | $707.95 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $707.95 Typical High $1,949.84 | Facility | None | $371.54 | $707.95 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $616.60 | Professional | None | $512.86 | $537.03 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | None | $478.63 | $478.63 | $501.19 |
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 $338.84 Median $467.74 Typical High $794.33 | Professional | None | $338.84 | $467.74 | $794.33 |
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 $173.78 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $173.78 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $69.18 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $263.03 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $52.48 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $34.67 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $346.74 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $245.47 | $346.74 | $380.19 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $354.81 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $186.21 | $354.81 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $269.15 Typical High $346.74 | Professional | 51 · Multiple procedures | $257.04 | $269.15 | $346.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $107.15 Typical High $138.04 | Professional | 80 · Assistant surgeon | $102.33 | $107.15 | $138.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $74.13 Typical High $95.50 | Professional | 81 · Minimal assistant surgeon | $72.44 | $74.13 | $95.50 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $74.13 Typical High $95.50 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $74.13 | $95.50 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $74.13 Typical High $95.50 | Professional | AS · PA/NP assist | $72.44 | $74.13 | $95.50 |
Where North Carolina sits
The same service costs 3.7 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· 6th of 51
$851
AK $1,445NJ $389
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.