How much rates vary
Facilitymedian $871 · 10th to 90th $380 to $8,318Professionalmedian $1,445 · 10th to 90th $851 to $2,291
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 $758.58 Median $1,000.00 Typical High $12,022.64 | Facility | None | $758.58 | $1,000.00 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,071.52 | Professional | None | $758.58 | $758.58 | $1,071.52 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,778.28 | $2,344.23 |
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 $912.01 Median $1,122.02 Typical High $2,089.30 | Professional | None | $912.01 | $1,122.02 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $3,467.37 | Facility | None | $758.58 | $912.01 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,513.56 | Professional | None | $741.31 | $1,096.48 | $1,513.56 |
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 $776.25 Median $1,096.48 Typical High $2,089.30 | Professional | None | $776.25 | $1,096.48 | $2,089.30 |
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 $380.19 Median $380.19 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $741.31 | Professional | 54 · Surgery only | $575.44 | $575.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $537.03 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $371.54 | $537.03 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $218.78 Typical High $436.52 | Professional | 80 · Assistant surgeon | $147.91 | $218.78 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $151.36 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $104.71 | $151.36 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $151.36 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $151.36 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $151.36 Typical High $309.03 | Professional | AS · PA/NP assist | $104.71 | $151.36 | $309.03 |
Where North Carolina sits
The same service costs 4.6 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· 15th of 51
$1,349
AK $3,162TX $692
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.