How much rates vary
Facilitymedian $2,239 · 10th to 90th $646 to $14,125Professionalmedian $1,202 · 10th to 90th $871 to $2,188
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 $812.83 Median $1,288.25 Typical High $10,471.29 | Facility | None | $812.83 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,000.00 | Professional | None | $812.83 | $812.83 | $1,000.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $2,238.72 | Professional | None | $912.01 | $1,548.82 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $2,187.76 | Professional | None | $870.96 | $1,148.15 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $3,311.31 | Facility | None | $812.83 | $954.99 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,412.54 | Professional | None | $977.24 | $1,096.48 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,995.26 | Professional | None | $794.33 | $1,023.29 | $1,995.26 |
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 $398.11 Median $398.11 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $398.11 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $691.83 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $165.96 | $165.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $549.54 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $501.19 | $549.54 | $1,174.90 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $223.87 Typical High $467.74 | Professional | 80 · Assistant surgeon | $199.53 | $223.87 | $467.74 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $154.88 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $141.25 | $154.88 | $331.13 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $154.88 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $154.88 | $331.13 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $154.88 Typical High $331.13 | Professional | AS · PA/NP assist | $141.25 | $154.88 | $331.13 |
Where North Carolina sits
The same service costs 6.2 times more in Oklahoma 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· 22nd of 51
$1,259
OK $3,631UT $589
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.