How much rates vary
Facilitymedian $851 · 10th to 90th $389 to $7,586Professionalmedian $708 · 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 $446.68 Median $457.09 Typical High $537.03 | Professional | None | $446.68 | $457.09 | $537.03 |
BCBS North Carolina Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,148.15 | Professional | None | $575.44 | $812.83 | $1,148.15 |
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 $489.78 Median $575.44 Typical High $912.01 | Professional | None | $489.78 | $575.44 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $1,621.81 | Facility | None | $457.09 | $549.54 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $741.31 | Professional | None | $489.78 | $549.54 | $741.31 |
United Setting Facility Modifier None Typical Low $338.84 Median $851.14 Typical High $5,011.87 | Facility | None | $338.84 | $851.14 | $5,011.87 |
United Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $1,122.02 | Professional | None | $416.87 | $602.56 | $1,122.02 |
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 $223.87 Median $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $371.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $269.15 Typical High $630.96 | Professional | 51 · Multiple procedures | $245.47 | $269.15 | $630.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $109.65 Typical High $257.04 | Professional | 80 · Assistant surgeon | $97.72 | $109.65 | $257.04 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $75.86 Typical High $177.83 | Professional | 81 · Minimal assistant surgeon | $69.18 | $75.86 | $177.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $75.86 Typical High $177.83 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $75.86 | $177.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $75.86 Typical High $177.83 | Professional | AS · PA/NP assist | $69.18 | $75.86 | $177.83 |
Where North Carolina sits
The same service costs 7.2 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· 14th of 51
$708
OK $2,042UT $282
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.