How much rates vary
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 $741.31 Median $741.31 Typical High $7,943.28 | Facility | None | $741.31 | $741.31 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $758.58 | Professional | None | $676.08 | $741.31 | $758.58 |
BCBS North Carolina Setting Professional Modifier None Typical Low $776.25 Median $1,288.25 Typical High $1,995.26 | Professional | None | $776.25 | $1,288.25 | $1,995.26 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $891.25 Typical High $1,288.25 | Facility | None | $741.31 | $891.25 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $707.95 | Professional | None | $501.19 | $707.95 | $707.95 |
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 $588.84 Median $776.25 Typical High $1,318.26 | Professional | None | $588.84 | $776.25 | $1,318.26 |
9 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 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $537.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $354.81 Typical High $354.81 | Professional | 51 · Multiple procedures | $251.19 | $354.81 | $354.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $141.25 Typical High $141.25 | Professional | 80 · Assistant surgeon | $100.00 | $141.25 | $141.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $70.79 Median $97.72 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $70.79 | $97.72 | $97.72 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $70.79 Median $97.72 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $70.79 | $97.72 | $97.72 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $97.72 Typical High $97.72 | Professional | AS · PA/NP assist | $70.79 | $97.72 | $97.72 |
Where North Carolina sits
The same service costs 3.8 times more in Alaska 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· 9th of 51
$1,175
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.