How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $5,129 · 10th to 90th $2,630 to $7,586
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 $2,630.27 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,630.27 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,388.44 | Professional | None | $2,630.27 | $2,630.27 | $3,388.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $8,128.31 | Professional | None | $3,801.89 | $5,248.07 | $8,128.31 |
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 $2,511.89 Median $3,801.89 Typical High $7,244.36 | Professional | None | $2,511.89 | $3,801.89 | $7,244.36 |
Medcost Setting Facility Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $2,630.27 | $3,162.28 | $10,471.29 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $5,495.41 | Professional | None | $2,630.27 | $3,235.94 | $5,495.41 |
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 $2,691.53 Median $3,801.89 Typical High $7,079.46 | Professional | None | $2,691.53 | $3,801.89 | $7,079.46 |
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 $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $676.08 | Professional | 53 · Discontinued | $524.81 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $501.19 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $2,344.23 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,318.26 Median $1,819.70 Typical High $3,801.89 | Professional | 51 · Multiple procedures | $1,318.26 | $1,819.70 | $3,801.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $724.44 Typical High $1,548.82 | Professional | 80 · Assistant surgeon | $524.81 | $724.44 | $1,548.82 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $512.86 Typical High $1,071.52 | Professional | 81 · Minimal assistant surgeon | $371.54 | $512.86 | $1,071.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $512.86 Typical High $1,071.52 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $512.86 | $1,071.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $512.86 Typical High $1,071.52 | Professional | AS · PA/NP assist | $371.54 | $512.86 | $1,071.52 |
Where North Carolina sits
The same service costs 6.9 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· 14th of 51
$4,467
AK $10,715TX $1,549
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.