How much rates vary
Facilitymedian $1,905 · 10th to 90th $646 to $5,129Professionalmedian $447 · 10th to 90th $263 to $832
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 $208.93 Median $371.54 Typical High $10,964.78 | Facility | None | $208.93 | $371.54 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $371.54 | Professional | None | $208.93 | $346.74 | $371.54 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,691.53 | Facility | None | $1,318.26 | $1,949.84 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $891.25 | Professional | None | $295.12 | $501.19 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $2,454.71 Typical High $4,073.80 | Facility | None | $1,258.93 | $2,454.71 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $549.54 | Professional | None | $223.87 | $295.12 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $891.25 | Professional | None | $416.87 | $416.87 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $1,548.82 Typical High $2,344.23 | Facility | None | $371.54 | $1,548.82 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $398.11 | Professional | None | $288.40 | $354.81 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | None | $269.15 | $269.15 | $288.40 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $489.78 | Professional | None | $204.17 | $295.12 | $489.78 |
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 $104.71 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $104.71 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $41.69 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $158.49 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $31.62 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.90 Typical High $37.15 | Professional | 56 · Pre-op care only | $20.89 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $218.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $147.91 | $218.78 | $257.04 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $588.84 Median $954.99 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $588.84 | $954.99 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $177.83 Typical High $213.80 | Professional | 51 · Multiple procedures | $144.54 | $177.83 | $213.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $70.79 Typical High $77.62 | Professional | 80 · Assistant surgeon | $57.54 | $70.79 | $77.62 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $40.74 Median $50.12 Typical High $53.70 | Professional | 81 · Minimal assistant surgeon | $40.74 | $50.12 | $53.70 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $40.74 Median $50.12 Typical High $53.70 | Professional | 82 · Assistant surgeon, no resident | $40.74 | $50.12 | $53.70 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $50.12 Typical High $53.70 | Professional | AS · PA/NP assist | $40.74 | $50.12 | $53.70 |
Where North Carolina sits
The same service costs 3.7 times more in Wyoming than in Texas. 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
$447
WY $891TX $240
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.