How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,738 · 10th to 90th $1,230 to $3,162
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 $1,202.26 Median $1,202.26 Typical High $7,943.28 | Facility | None | $1,202.26 | $1,202.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,202.26 | $1,445.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,230.27 Median $2,290.87 Typical High $3,311.31 | Professional | None | $1,230.27 | $2,290.87 | $3,311.31 |
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 $1,348.96 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,659.59 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $5,248.07 | Facility | None | $1,202.26 | $1,445.44 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,584.89 | $1,949.84 |
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 $1,174.90 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,174.90 | $1,513.56 | $2,951.21 |
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 $602.56 Median $602.56 Typical High $724.44 | Professional | 52 · Reduced service | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $218.78 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,023.29 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $776.25 Median $794.33 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $776.25 | $794.33 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $316.23 Typical High $691.83 | Professional | 80 · Assistant surgeon | $309.03 | $316.23 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $223.87 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $218.78 | $223.87 | $489.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $223.87 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $223.87 | $489.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $223.87 Typical High $489.78 | Professional | AS · PA/NP assist | $218.78 | $223.87 | $489.78 |
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· 18th of 51
$1,738
AK $4,898TX $724
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.