How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,291 · 10th to 90th $1,514 to $4,571
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 $1,513.56 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,513.56 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,513.56 | $1,949.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,089.30 Median $3,019.95 Typical High $4,677.35 | Professional | None | $2,089.30 | $3,019.95 | $4,677.35 |
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 $1,445.44 Median $2,187.76 Typical High $4,168.69 | Professional | None | $1,445.44 | $2,187.76 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $5,128.61 | Facility | None | $1,513.56 | $1,819.70 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,862.09 | $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 $1,548.82 Median $2,187.76 Typical High $4,168.69 | Professional | None | $1,548.82 | $2,187.76 | $4,168.69 |
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 $758.58 Median $758.58 Typical High $977.24 | Professional | 52 · Reduced service | $758.58 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $389.05 | Professional | 53 · Discontinued | $302.00 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $194.98 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $1,047.13 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $741.31 | $1,047.13 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $416.87 Typical High $891.25 | Professional | 80 · Assistant surgeon | $302.00 | $416.87 | $891.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $295.12 Typical High $616.60 | Professional | 81 · Minimal assistant surgeon | $208.93 | $295.12 | $616.60 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $295.12 Typical High $616.60 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $295.12 | $616.60 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $295.12 Typical High $616.60 | Professional | AS · PA/NP assist | $208.93 | $295.12 | $616.60 |
Where North Carolina sits
The same service costs 5.6 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
$2,291
AK $6,166TX $1,096
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.