How much rates vary
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 $380.19 Median $575.44 Typical High $11,220.18 | Facility | None | $380.19 | $575.44 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $562.34 | Professional | None | $380.19 | $380.19 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $676.08 | Professional | None | $363.08 | $588.84 | $676.08 |
BCBS North Carolina Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,096.48 | Professional | None | $436.52 | $691.83 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $794.33 | Professional | None | $398.11 | $407.38 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $912.01 | Professional | None | $645.65 | $645.65 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $537.03 | Professional | None | $363.08 | $512.86 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | None | $407.38 | $407.38 | $416.87 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $12,882.50 Typical High $23,988.33 | Facility | None | $7,943.28 | $12,882.50 | $23,988.33 |
United Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $724.44 | Professional | None | $331.13 | $407.38 | $724.44 |
7 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 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | 54 · Surgery only | $288.40 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $316.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $263.03 Typical High $371.54 | Professional | 51 · Multiple procedures | $181.97 | $263.03 | $371.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $104.71 Typical High $125.89 | Professional | 80 · Assistant surgeon | $72.44 | $104.71 | $125.89 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $51.29 Median $74.13 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $51.29 | $74.13 | $87.10 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $51.29 Median $74.13 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $51.29 | $74.13 | $87.10 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $74.13 Typical High $87.10 | Professional | AS · PA/NP assist | $51.29 | $74.13 | $87.10 |
Where North Carolina sits
The same service costs 4.2 times more in Wyoming 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· 11th of 51
$646
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.