How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $3,162 · 10th to 90th $2,138 to $6,026
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 $2,041.74 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,041.74 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,041.74 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,137.96 Median $3,981.07 Typical High $6,456.54 | Professional | None | $2,137.96 | $3,981.07 | $6,456.54 |
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 $2,454.71 Median $3,019.95 Typical High $5,623.41 | Professional | None | $2,454.71 | $3,019.95 | $5,623.41 |
Medcost Setting Facility Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $9,332.54 | Facility | None | $2,041.74 | $2,454.71 | $9,332.54 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $3,548.13 | Professional | None | $2,089.30 | $2,754.23 | $3,548.13 |
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 $2,089.30 Median $3,019.95 Typical High $5,623.41 | Professional | None | $2,089.30 | $3,019.95 | $5,623.41 |
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 $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $524.81 | Professional | 53 · Discontinued | $407.38 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $389.05 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,819.70 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,412.54 Typical High $3,019.95 | Professional | 51 · Multiple procedures | $1,023.29 | $1,412.54 | $3,019.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $562.34 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $416.87 | $562.34 | $1,202.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $398.11 Typical High $851.14 | Professional | 81 · Minimal assistant surgeon | $288.40 | $398.11 | $851.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $398.11 Typical High $851.14 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $398.11 | $851.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $398.11 Typical High $851.14 | Professional | AS · PA/NP assist | $288.40 | $398.11 | $851.14 |
Where North Carolina sits
The same service costs 5.4 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· 22nd of 51
$3,020
AK $8,318TX $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.