How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,995 · 10th to 90th $794 to $3,890
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 $1,318.26 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,318.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,318.26 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None Typical Low $794.33 Median $2,630.27 Typical High $4,073.80 | Professional | None | $794.33 | $2,630.27 | $4,073.80 |
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 $1,479.11 Median $1,949.84 Typical High $3,630.78 | Professional | None | $1,479.11 | $1,949.84 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $5,754.40 | Facility | None | $1,318.26 | $1,584.89 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,698.24 | $2,511.89 |
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 $1,905.46 Typical High $3,630.78 | Professional | None | $1,348.96 | $1,905.46 | $3,630.78 |
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 $660.69 Median $660.69 Typical High $851.14 | Professional | 52 · Reduced service | $660.69 | $660.69 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $257.04 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $169.82 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,202.26 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $954.99 Typical High $1,949.84 | Professional | 51 · Multiple procedures | $691.83 | $954.99 | $1,949.84 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $380.19 Typical High $776.25 | Professional | 80 · Assistant surgeon | $275.42 | $380.19 | $776.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $263.03 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $194.98 | $263.03 | $537.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $263.03 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $263.03 | $537.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $263.03 Typical High $537.03 | Professional | AS · PA/NP assist | $194.98 | $263.03 | $537.03 |
Where North Carolina sits
The same service costs 5.4 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· 23rd of 51
$1,950
AK $5,370TX $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.