How much rates vary
Facilitymedian $1,905 · 10th to 90th $676 to $5,623Professionalmedian $331 · 10th to 90th $209 to $513
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 $190.55 Median $263.03 Typical High $10,471.29 | Facility | None | $190.55 | $263.03 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $302.00 | Professional | None | $190.55 | $190.55 | $302.00 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $5,370.32 | Facility | None | $1,348.96 | $2,137.96 | $5,370.32 |
BCBS North Carolina Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $537.03 | Professional | None | $239.88 | $346.74 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $2,951.21 | Facility | None | $794.33 | $2,454.71 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $389.05 | Professional | None | $204.17 | $213.80 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $457.09 | Professional | None | $302.00 | $302.00 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $2,454.71 | Facility | None | $676.08 | $1,096.48 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $309.03 | Professional | None | $186.21 | $245.47 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | None | $213.80 | $213.80 | $223.87 |
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 $162.18 Median $204.17 Typical High $363.08 | Professional | None | $162.18 | $204.17 | $363.08 |
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 $95.50 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $38.02 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | 54 · Surgery only | $144.54 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $158.49 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $363.08 Median $602.56 Typical High $1,288.25 | Facility | 51 · Multiple procedures | $363.08 | $602.56 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $93.33 Median $125.89 Typical High $154.88 | Professional | 51 · Multiple procedures | $93.33 | $125.89 | $154.88 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $48.98 Typical High $61.66 | Professional | 80 · Assistant surgeon | $37.15 | $48.98 | $61.66 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.30 Median $34.67 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $26.30 | $34.67 | $43.65 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.30 Median $34.67 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $26.30 | $34.67 | $43.65 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $26.30 Median $34.67 Typical High $43.65 | Professional | AS · PA/NP assist | $26.30 | $34.67 | $43.65 |
Where North Carolina sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$331
AK $813UT $138
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.