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 $346.74 Median $1,000.00 Typical High $7,943.28 | Facility | None | $346.74 | $1,000.00 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $467.74 | Professional | None | $346.74 | $346.74 | $467.74 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $5,128.61 | Facility | None | $1,288.25 | $1,995.26 | $5,128.61 |
BCBS North Carolina Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $977.24 | Professional | None | $467.74 | $676.08 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,290.87 Typical High $3,388.44 | Facility | None | $457.09 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $933.25 | Professional | None | $380.19 | $489.78 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $2,511.89 | Facility | None | $371.54 | $776.25 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $588.84 | Professional | None | $416.87 | $478.63 | $588.84 |
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 $331.13 Median $426.58 Typical High $891.25 | Professional | None | $331.13 | $426.58 | $891.25 |
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 $263.03 Median $263.03 Typical High $316.23 | Professional | 54 · Surgery only | $263.03 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $295.12 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $524.81 Typical High $1,258.93 | Facility | 51 · Multiple procedures | $186.21 | $524.81 | $1,258.93 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $239.88 Typical High $512.86 | Professional | 51 · Multiple procedures | $208.93 | $239.88 | $512.86 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $204.17 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $204.17 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $67.61 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $57.54 | $67.61 | $144.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $67.61 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $67.61 | $144.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $67.61 Typical High $144.54 | Professional | AS · PA/NP assist | $57.54 | $67.61 | $144.54 |
Where North Carolina sits
The same service costs 6.2 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· 20th of 51
$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.