How much rates vary
Facilitymedian $1,778 · 10th to 90th $417 to $5,623Professionalmedian $457 · 10th to 90th $316 to $832
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 $354.81 Median $870.96 Typical High $7,943.28 | Facility | None | $354.81 | $870.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $407.38 | Professional | None | $354.81 | $354.81 | $407.38 |
BCBS North Carolina Setting Facility Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $4,466.84 | Facility | None | $1,122.02 | $1,778.28 | $4,466.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $870.96 | Professional | None | $416.87 | $575.44 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,344.23 Typical High $3,467.37 | Facility | None | $457.09 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $870.96 | Professional | None | $302.00 | $416.87 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $2,398.83 | Facility | None | $371.54 | $776.25 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $588.84 | Professional | None | $295.12 | $389.05 | $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 $302.00 Median $426.58 Typical High $870.96 | Professional | None | $302.00 | $426.58 | $870.96 |
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 $177.83 Median $177.83 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | 53 · Discontinued | $70.79 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $275.42 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $186.21 Median $446.68 Typical High $1,548.82 | Facility | 51 · Multiple procedures | $186.21 | $446.68 | $1,548.82 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $194.98 Typical High $478.63 | Professional | 51 · Multiple procedures | $147.91 | $194.98 | $478.63 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $77.62 Typical High $190.55 | Professional | 80 · Assistant surgeon | $58.88 | $77.62 | $190.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $40.74 Median $54.95 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $40.74 | $54.95 | $131.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $40.74 Median $54.95 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $40.74 | $54.95 | $131.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $54.95 Typical High $131.83 | Professional | AS · PA/NP assist | $40.74 | $54.95 | $131.83 |
Where North Carolina sits
The same service costs 8.5 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· 23rd of 51
$525
OK $2,138UT $251
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.