How much rates vary
Facilitymedian $741 · 10th to 90th $347 to $2,291Professionalmedian $234 · 10th to 90th $145 to $468
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 $151.36 Median $177.83 Typical High $7,413.10 | Facility | None | $151.36 | $177.83 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $190.55 | Professional | None | $151.36 | $173.78 | $190.55 |
BCBS North Carolina Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $794.33 | Facility | None | $398.11 | $588.84 | $794.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $144.54 Median $302.00 Typical High $478.63 | Professional | None | $144.54 | $302.00 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,348.96 | Facility | None | $457.09 | $1,071.52 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $416.87 | Professional | None | $154.88 | $208.93 | $416.87 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $389.05 Typical High $977.24 | Facility | None | $213.80 | $389.05 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $302.00 | Professional | None | $173.78 | $199.53 | $302.00 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $426.58 | Professional | None | $141.25 | $190.55 | $426.58 |
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 $75.86 Median $85.11 Typical High $89.13 | Professional | 52 · Reduced service | $75.86 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.88 Typical High $36.31 | Professional | 53 · Discontinued | $30.20 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $128.82 Typical High $134.90 | Professional | 54 · Surgery only | $114.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $22.91 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.98 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.14 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $120.23 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $107.15 | $120.23 | $125.89 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $154.88 Median $223.87 Typical High $758.58 | Facility | 51 · Multiple procedures | $154.88 | $223.87 | $758.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $100.00 Typical High $245.47 | Professional | 51 · Multiple procedures | $87.10 | $100.00 | $245.47 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $34.67 Median $39.81 Typical High $97.72 | Professional | 80 · Assistant surgeon | $34.67 | $39.81 | $97.72 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $24.55 Median $27.54 Typical High $67.61 | Professional | 81 · Minimal assistant surgeon | $24.55 | $27.54 | $67.61 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $24.55 Median $27.54 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $24.55 | $27.54 | $67.61 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $27.54 Typical High $67.61 | Professional | AS · PA/NP assist | $24.55 | $27.54 | $67.61 |
Where North Carolina sits
The same service costs 4.6 times more in Alaska 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
$269
AK $759UT $166
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.