How much rates vary
Facilitymedian $646 · 10th to 90th $295 to $1,862Professionalmedian $331 · 10th to 90th $204 to $575
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 $190.55 Median $257.04 Typical High $7,585.78 | Facility | None | $190.55 | $257.04 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $269.15 | Professional | None | $190.55 | $251.19 | $269.15 |
BCBS North Carolina Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $1,621.81 | Facility | None | $407.38 | $630.96 | $1,621.81 |
BCBS North Carolina Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $602.56 | Professional | None | $257.04 | $389.05 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $812.83 Typical High $1,737.80 | Facility | None | $524.81 | $812.83 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $575.44 | Professional | None | $204.17 | $257.04 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $562.34 Typical High $977.24 | Facility | None | $309.03 | $562.34 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $416.87 | Professional | None | $263.03 | $288.40 | $416.87 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $512.86 | Professional | None | $169.82 | $245.47 | $512.86 |
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 $95.50 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $95.50 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $47.86 Typical High $52.48 | Professional | 53 · Discontinued | $38.02 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $141.25 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $28.18 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.05 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $165.96 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $131.83 | $165.96 | $181.97 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $173.78 Median $302.00 Typical High $524.81 | Facility | 51 · Multiple procedures | $173.78 | $302.00 | $524.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $144.54 Typical High $302.00 | Professional | 51 · Multiple procedures | $131.83 | $144.54 | $302.00 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $57.54 Typical High $120.23 | Professional | 80 · Assistant surgeon | $52.48 | $57.54 | $120.23 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $40.74 Typical High $85.11 | Professional | 81 · Minimal assistant surgeon | $36.31 | $40.74 | $85.11 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $40.74 Typical High $85.11 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $40.74 | $85.11 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $40.74 Typical High $85.11 | Professional | AS · PA/NP assist | $36.31 | $40.74 | $85.11 |
Where North Carolina sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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
$339
AK $912KY $214
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.