How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,570 · 10th to 90th $1,549 to $3,981
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 $1,548.82 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,548.82 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,548.82 | $1,949.84 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $4,365.16 | Professional | None | $1,905.46 | $2,630.27 | $4,365.16 |
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 $1,412.54 Median $2,089.30 Typical High $4,265.80 | Professional | None | $1,412.54 | $2,089.30 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $5,495.41 | Facility | None | $1,548.82 | $1,862.09 | $5,495.41 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,621.81 | $2,818.38 |
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 $1,412.54 Median $1,905.46 Typical High $4,168.69 | Professional | None | $1,412.54 | $1,905.46 | $4,168.69 |
10 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 $776.25 Median $776.25 Typical High $977.24 | Professional | 52 · Reduced service | $776.25 | $776.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $389.05 | Professional | 53 · Discontinued | $309.03 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $295.12 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $194.98 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $194.98 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $812.83 Typical High $2,238.72 | Professional | 51 · Multiple procedures | $724.44 | $812.83 | $2,238.72 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $323.59 Typical High $891.25 | Professional | 80 · Assistant surgeon | $288.40 | $323.59 | $891.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $229.09 Typical High $630.96 | Professional | 81 · Minimal assistant surgeon | $204.17 | $229.09 | $630.96 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $229.09 Typical High $630.96 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $229.09 | $630.96 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $229.09 Typical High $630.96 | Professional | AS · PA/NP assist | $204.17 | $229.09 | $630.96 |
Where North Carolina sits
The same service costs 4.7 times more in Alaska than in Delaware. 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· 15th of 51
$2,512
AK $6,166DE $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.