How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,585 · 10th to 90th $1,096 to $2,818
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 $1,096.48 Median $1,096.48 Typical High $7,943.28 | Facility | None | $1,096.48 | $1,096.48 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,096.48 | $1,348.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,096.48 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,096.48 | $2,041.74 | $3,019.95 |
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 $1,122.02 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,122.02 | $1,479.11 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $3,981.07 | Facility | None | $1,096.48 | $1,318.26 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,445.44 | $1,819.70 |
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 $1,096.48 Median $1,348.96 Typical High $2,691.53 | Professional | None | $1,096.48 | $1,348.96 | $2,691.53 |
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 $549.54 Median $549.54 Typical High $676.08 | Professional | 52 · Reduced service | $549.54 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $933.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $724.44 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $616.60 | $724.44 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $288.40 Typical High $645.65 | Professional | 80 · Assistant surgeon | $245.47 | $288.40 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $204.17 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $169.82 | $204.17 | $446.68 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $204.17 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $204.17 | $446.68 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $446.68 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $446.68 |
Where North Carolina sits
The same service costs 6.8 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· 22nd of 51
$1,549
AK $4,571TX $676
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.