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 $213.80 Median $2,398.83 Typical High $7,585.78 | Facility | None | $213.80 | $2,398.83 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $1,584.89 Typical High $2,398.83 | Professional | None | $213.80 | $1,584.89 | $2,398.83 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $4,466.84 | Facility | None | $1,122.02 | $1,737.80 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $380.19 Median $1,380.38 Typical High $4,677.35 | Professional | None | $380.19 | $1,380.38 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,659.59 Typical High $2,630.27 | Facility | None | $676.08 | $1,659.59 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $1,819.70 Typical High $4,073.80 | Professional | None | $295.12 | $1,819.70 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,348.96 Typical High $2,398.83 | Facility | None | $870.96 | $1,348.96 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,949.84 | $1,949.84 | $3,801.89 |
United Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
United Setting Professional Modifier None Typical Low $223.87 Median $1,288.25 Typical High $3,801.89 | Professional | None | $223.87 | $1,288.25 | $3,801.89 |
8 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 $162.18 Median $302.00 Typical High $1,778.28 | Professional | 54 · Surgery only | $162.18 | $302.00 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $281.84 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $151.36 | $281.84 | $1,659.59 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $436.52 Median $676.08 Typical High $1,047.13 | Facility | 51 · Multiple procedures | $436.52 | $676.08 | $1,047.13 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $977.24 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $977.24 | $977.24 | $2,884.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $389.05 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $389.05 | $389.05 | $1,148.15 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $275.42 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $275.42 | $275.42 | $812.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $275.42 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $275.42 | $812.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $275.42 Typical High $812.83 | Professional | AS · PA/NP assist | $275.42 | $275.42 | $812.83 |
Where North Carolina sits
The same service costs 7.1 times more in Oregon 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· 31st of 51
$1,514
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.