How much rates vary
Facilitymedian $4,677 · 10th to 90th $871 to $8,913Professionalmedian $1,122 · 10th to 90th $794 to $1,995
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 $758.58 Median $758.58 Typical High $7,943.28 | Facility | None | $758.58 | $758.58 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $851.14 | Professional | None | $758.58 | $758.58 | $851.14 |
BCBS North Carolina Setting Facility Modifier None Typical Low $4,265.80 Median $6,309.57 Typical High $8,912.51 | Facility | None | $4,265.80 | $6,309.57 | $8,912.51 |
BCBS North Carolina Setting Professional Modifier None Typical Low $812.83 Median $1,445.44 Typical High $1,995.26 | Professional | None | $812.83 | $1,445.44 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,677.35 Typical High $7,762.47 | Facility | None | $602.56 | $4,677.35 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,949.84 | Professional | None | $831.76 | $1,000.00 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $5,011.87 Typical High $10,471.29 | Facility | None | $776.25 | $5,011.87 | $10,471.29 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,318.26 | Professional | None | $891.25 | $1,000.00 | $1,318.26 |
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 $724.44 Median $1,047.13 Typical High $1,862.09 | Professional | None | $724.44 | $1,047.13 | $1,862.09 |
11 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 $380.19 Median $380.19 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $588.84 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $501.19 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $457.09 | $501.19 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $199.53 Typical High $436.52 | Professional | 80 · Assistant surgeon | $181.97 | $199.53 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $138.04 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $128.82 | $138.04 | $302.00 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $138.04 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $138.04 | $302.00 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $138.04 Typical High $302.00 | Professional | AS · PA/NP assist | $128.82 | $138.04 | $302.00 |
Where North Carolina sits
The same service costs 6.8 times more in Oklahoma 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· 19th of 51
$1,259
OK $3,548TX $525
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.