How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,291 · 10th to 90th $1,622 to $4,467
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 $1,479.11 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,479.11 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,479.11 | $1,479.11 | $1,905.46 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $4,570.88 | Professional | None | $2,187.76 | $2,951.21 | $4,570.88 |
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 $1,698.24 Median $2,187.76 Typical High $4,073.80 | Professional | None | $1,698.24 | $2,187.76 | $4,073.80 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $7,244.36 | Facility | None | $1,479.11 | $1,778.28 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,949.84 | $3,019.95 |
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 $1,513.56 Median $2,137.96 Typical High $4,073.80 | Professional | None | $1,513.56 | $2,137.96 | $4,073.80 |
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 $741.31 Median $741.31 Typical High $954.99 | Professional | 52 · Reduced service | $741.31 | $741.31 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $380.19 | Professional | 53 · Discontinued | $295.12 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $288.40 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $190.55 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,348.96 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $1,000.00 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $724.44 | $1,000.00 | $2,137.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $398.11 Typical High $870.96 | Professional | 80 · Assistant surgeon | $288.40 | $398.11 | $870.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $275.42 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $204.17 | $275.42 | $602.56 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $275.42 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $275.42 | $602.56 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $275.42 Typical High $602.56 | Professional | AS · PA/NP assist | $204.17 | $275.42 | $602.56 |
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· 19th of 51
$2,291
AK $6,026TX $1,072
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.