How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $12,882Professionalmedian $2,344 · 10th to 90th $1,148 to $3,548
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 $1,174.90 Median $1,288.25 Typical High $10,471.29 | Facility | None | $1,174.90 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,174.90 | $1,258.93 |
BCBS North Carolina Setting Facility Modifier None Typical Low $3,890.45 Median $6,309.57 Typical High $10,000.00 | Facility | None | $3,890.45 | $6,309.57 | $10,000.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $3,630.78 | Professional | None | $1,513.56 | $2,630.27 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $6,760.83 Typical High $11,220.18 | Facility | None | $602.56 | $6,760.83 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $6,918.31 Typical High $14,454.40 | Facility | None | $1,258.93 | $6,918.31 | $14,454.40 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,148.15 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $17,782.79 | Facility | None | $1,380.38 | $4,365.16 | $17,782.79 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,479.11 | $2,884.03 |
10 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 $562.34 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $562.34 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $117.49 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $575.44 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $575.44 | $575.44 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | 80 · Assistant surgeon | $229.09 | $229.09 | $457.09 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $158.49 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $158.49 | $158.49 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $158.49 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $158.49 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $158.49 Typical High $316.23 | Professional | AS · PA/NP assist | $158.49 | $158.49 | $316.23 |
Where North Carolina sits
The same service costs 5.9 times more in Texas 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· 9th of 51
$2,344
TX $5,754KY $977
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.