How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $3,631 · 10th to 90th $1,995 to $5,495
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 $1,995.26 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,511.89 | Professional | None | $1,995.26 | $1,995.26 | $2,511.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,623.41 | Professional | None | $2,570.40 | $3,801.89 | $5,623.41 |
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 $1,995.26 Median $2,818.38 Typical High $5,495.41 | Professional | None | $1,995.26 | $2,818.38 | $5,495.41 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $7,943.28 | Facility | None | $1,995.26 | $2,398.83 | $7,943.28 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,905.46 | $2,398.83 | $3,467.37 |
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 $1,995.26 Median $2,691.53 Typical High $5,370.32 | Professional | None | $1,995.26 | $2,691.53 | $5,370.32 |
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 $1,000.00 Median $1,000.00 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $512.86 | Professional | 53 · Discontinued | $398.11 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $380.19 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $251.19 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,202.26 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $933.25 | $1,202.26 | $2,884.03 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $478.63 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $380.19 | $478.63 | $1,174.90 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $331.13 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $263.03 | $331.13 | $812.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $331.13 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $331.13 | $812.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $331.13 Typical High $812.83 | Professional | AS · PA/NP assist | $263.03 | $331.13 | $812.83 |
Where North Carolina sits
The same service costs 5.2 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· 12th of 51
$3,388
AK $8,128TX $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.