How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $3,162 · 10th to 90th $1,660 to $6,310
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 $2,089.30 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,089.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,691.53 | Professional | None | $2,089.30 | $2,089.30 | $2,691.53 |
BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $4,073.80 Typical High $6,606.93 | Professional | None | $1,659.59 | $4,073.80 | $6,606.93 |
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 $2,238.72 Median $3,090.30 Typical High $5,754.40 | Professional | None | $2,238.72 | $3,090.30 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $9,332.54 | Facility | None | $2,089.30 | $2,511.89 | $9,332.54 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $4,073.80 | Professional | None | $1,995.26 | $2,570.40 | $4,073.80 |
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 $2,187.76 Median $3,090.30 Typical High $5,754.40 | Professional | None | $2,187.76 | $3,090.30 | $5,754.40 |
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 $1,047.13 Median $1,047.13 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $537.03 | Professional | 53 · Discontinued | $426.58 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,862.09 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,380.38 Typical High $3,090.30 | Professional | 51 · Multiple procedures | $1,000.00 | $1,380.38 | $3,090.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $549.54 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $398.11 | $549.54 | $1,230.27 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $389.05 Typical High $870.96 | Professional | 81 · Minimal assistant surgeon | $281.84 | $389.05 | $870.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $389.05 Typical High $870.96 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $389.05 | $870.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $389.05 Typical High $870.96 | Professional | AS · PA/NP assist | $281.84 | $389.05 | $870.96 |
Where North Carolina sits
The same service costs 6.6 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· 23rd of 51
$3,020
AK $8,710TX $1,318
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.