How much rates vary
Facilitymedian $1,905 · 10th to 90th $646 to $5,623Professionalmedian $417 · 10th to 90th $275 to $646
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 $239.88 Median $354.81 Typical High $10,471.29 | Facility | None | $239.88 | $354.81 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $295.12 | Professional | None | $239.88 | $239.88 | $295.12 |
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 $323.59 Median $446.68 Typical High $676.08 | Professional | None | $323.59 | $446.68 | $676.08 |
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 $269.15 Median $275.42 Typical High $489.78 | Professional | None | $269.15 | $275.42 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $575.44 | Professional | None | $398.11 | $398.11 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,949.84 | Facility | None | $676.08 | $1,096.48 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $380.19 | Professional | None | $234.42 | $331.13 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $323.59 | Professional | None | $302.00 | $302.00 | $323.59 |
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 $208.93 Median $263.03 Typical High $446.68 | Professional | None | $208.93 | $263.03 | $446.68 |
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 $120.23 Median $120.23 Typical High $141.25 | Professional | 52 · Reduced service | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 54 · Surgery only | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $41.69 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $194.98 |
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 $117.49 Median $165.96 Typical High $218.78 | Professional | 51 · Multiple procedures | $117.49 | $165.96 | $218.78 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $66.07 Typical High $79.43 | Professional | 80 · Assistant surgeon | $46.77 | $66.07 | $79.43 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $32.36 Median $45.71 Typical High $56.23 | Professional | 81 · Minimal assistant surgeon | $32.36 | $45.71 | $56.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $32.36 Median $45.71 Typical High $56.23 | Professional | 82 · Assistant surgeon, no resident | $32.36 | $45.71 | $56.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $45.71 Typical High $56.23 | Professional | AS · PA/NP assist | $32.36 | $45.71 | $56.23 |
Where North Carolina sits
The same service costs 6.0 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
$417
AK $1,000UT $166
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.