How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,138 · 10th to 90th $1,259 to $3,311
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 $1,122.02 Median $1,122.02 Typical High $7,943.28 | Facility | None | $1,122.02 | $1,122.02 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,122.02 | $1,445.44 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,238.72 | $3,388.44 |
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 $1,348.96 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,659.59 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $6,165.95 | Facility | None | $1,122.02 | $1,348.96 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,659.59 | $2,238.72 |
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 $1,148.15 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,659.59 | $3,019.95 |
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 $562.34 Median $562.34 Typical High $724.44 | Professional | 52 · Reduced service | $562.34 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,000.00 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $831.76 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $549.54 | $831.76 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $331.13 Typical High $645.65 | Professional | 80 · Assistant surgeon | $218.78 | $331.13 | $645.65 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $229.09 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $151.36 | $229.09 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $229.09 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $229.09 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $229.09 Typical High $457.09 | Professional | AS · PA/NP assist | $151.36 | $229.09 | $457.09 |
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· 12th of 51
$2,042
AK $4,571TX $813
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.