How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $3,548 · 10th to 90th $1,905 to $4,898
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 $1,288.25 Median $1,905.46 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,905.46 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,905.46 | $1,905.46 | $2,344.23 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,454.71 Median $3,630.78 Typical High $5,248.07 | Professional | None | $2,454.71 | $3,630.78 | $5,248.07 |
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 $1,819.70 Median $2,454.71 Typical High $5,011.87 | Professional | None | $1,819.70 | $2,454.71 | $5,011.87 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $5,888.44 | Facility | None | $1,905.46 | $2,290.87 | $5,888.44 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,398.83 | $3,162.28 |
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 $1,819.70 Median $2,238.72 Typical High $4,677.35 | Professional | None | $1,819.70 | $2,238.72 | $4,677.35 |
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 $954.99 Median $954.99 Typical High $1,174.90 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $467.74 | Professional | 53 · Discontinued | $380.19 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $234.42 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,621.81 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $1,202.26 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $912.01 | $1,202.26 | $2,754.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $478.63 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $363.08 | $478.63 | $1,096.48 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $338.84 Typical High $776.25 | Professional | 81 · Minimal assistant surgeon | $257.04 | $338.84 | $776.25 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $338.84 Typical High $776.25 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $338.84 | $776.25 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $338.84 Typical High $776.25 | Professional | AS · PA/NP assist | $257.04 | $338.84 | $776.25 |
Where North Carolina sits
The same service costs 7.8 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· 11th of 51
$3,467
AK $7,762TX $1,000
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.