How much rates vary
Facilitymedian $2,239 · 10th to 90th $646 to $13,183Professionalmedian $1,148 · 10th to 90th $794 to $2,042
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 $794.33 Median $1,148.15 Typical High $10,471.29 | Facility | None | $794.33 | $1,148.15 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,479.11 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $29,512.09 | Facility | None | $478.63 | $851.14 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,659.59 | Professional | None | $870.96 | $1,047.13 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $2,884.03 | Facility | None | $794.33 | $954.99 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,318.26 | Professional | None | $870.96 | $1,000.00 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,949.84 | Professional | None | $758.58 | $1,096.48 | $1,949.84 |
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 $398.11 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $398.11 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $602.56 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $645.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $501.19 Typical High $1,148.15 | Professional | 51 · Multiple procedures | $436.52 | $501.19 | $1,148.15 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $199.53 Typical High $457.09 | Professional | 80 · Assistant surgeon | $173.78 | $199.53 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $123.03 Median $138.04 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $123.03 | $138.04 | $323.59 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $123.03 Median $138.04 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $123.03 | $138.04 | $323.59 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $138.04 Typical High $323.59 | Professional | AS · PA/NP assist | $123.03 | $138.04 | $323.59 |
Where North Carolina sits
The same service costs 8.5 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
$1,202
OK $3,162TX $372
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.