How much rates vary
Facilitymedian $1,738 · 10th to 90th $646 to $5,248Professionalmedian $759 · 10th to 90th $457 to $1,122
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 $457.09 Median $1,148.15 Typical High $7,943.28 | Facility | None | $457.09 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $741.31 | Professional | None | $457.09 | $457.09 | $741.31 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,621.81 | $2,187.76 |
BCBS North Carolina Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,148.15 | Professional | None | $549.54 | $794.33 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,344.23 Typical High $3,467.37 | Facility | None | $602.56 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,122.02 | Professional | None | $457.09 | $588.84 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $933.25 Typical High $2,398.83 | Facility | None | $524.81 | $933.25 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $741.31 | Professional | None | $478.63 | $549.54 | $741.31 |
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 $416.87 Median $588.84 Typical High $1,122.02 | Professional | None | $416.87 | $588.84 | $1,122.02 |
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 $223.87 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $223.87 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $354.81 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $263.03 Median $489.78 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $263.03 | $489.78 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $239.88 Median $275.42 Typical High $630.96 | Professional | 51 · Multiple procedures | $239.88 | $275.42 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $109.65 Typical High $257.04 | Professional | 80 · Assistant surgeon | $95.50 | $109.65 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $67.61 Median $77.62 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $67.61 | $77.62 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $67.61 Median $77.62 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $67.61 | $77.62 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $77.62 Typical High $177.83 | Professional | AS · PA/NP assist | $67.61 | $77.62 | $177.83 |
Where North Carolina sits
The same service costs 8.9 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· 17th of 51
$759
OK $2,754UT $309
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.