How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,042 · 10th to 90th $1,259 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 $1,412.54 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,412.54 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $2,691.53 Typical High $3,801.89 | Professional | None | $1,258.93 | $2,691.53 | $3,801.89 |
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 $3,715.35 | Professional | None | $1,584.89 | $1,905.46 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $6,025.60 | Facility | None | $1,380.38 | $1,698.24 | $6,025.60 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,905.46 | $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 $3,467.37 | Professional | None | $1,348.96 | $1,778.28 | $3,467.37 |
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 $707.95 Median $707.95 Typical High $851.14 | Professional | 52 · Reduced service | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $954.99 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $933.25 | $954.99 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $380.19 Typical High $776.25 | Professional | 80 · Assistant surgeon | $371.54 | $380.19 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $269.15 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $263.03 | $269.15 | $549.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $269.15 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $269.15 | $549.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $269.15 Typical High $549.54 | Professional | AS · PA/NP assist | $263.03 | $269.15 | $549.54 |
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· 19th of 51
$1,995
AK $5,754TX $741
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.