How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,042 · 10th to 90th $1,445 to $3,715
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 $1,348.96 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,348.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,348.96 | $1,659.59 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $2,570.40 Typical High $3,715.35 | Professional | None | $1,584.89 | $2,570.40 | $3,715.35 |
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 $1,584.89 Median $1,905.46 Typical High $3,548.13 | Professional | None | $1,584.89 | $1,905.46 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $6,309.57 | Facility | None | $1,348.96 | $1,621.81 | $6,309.57 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,949.84 | $2,398.83 |
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 $1,348.96 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,348.96 | $1,778.28 | $3,311.31 |
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 $676.08 Median $676.08 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,148.15 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $954.99 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $891.25 | $954.99 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $389.05 Typical High $794.33 | Professional | 80 · Assistant surgeon | $363.08 | $389.05 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $269.15 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $251.19 | $269.15 | $549.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $269.15 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $269.15 | $549.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $269.15 Typical High $549.54 | Professional | AS · PA/NP assist | $251.19 | $269.15 | $549.54 |
Where North Carolina sits
The same service costs 7.4 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· 20th of 51
$1,950
AK $5,623TX $759
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.