How much rates vary
Facilitymedian $977 · 10th to 90th $380 to $7,244Professionalmedian $1,698 · 10th to 90th $1,072 to $2,754
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 $977.24 Median $977.24 Typical High $7,943.28 | Facility | None | $977.24 | $977.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | None | $977.24 | $977.24 | $1,288.25 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,778.28 | $2,951.21 |
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 $1,071.52 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,412.54 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,148.15 Typical High $3,715.35 | Facility | None | $977.24 | $1,148.15 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,621.81 | Professional | None | $933.25 | $1,174.90 | $1,621.81 |
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 $977.24 Median $1,380.38 Typical High $2,630.27 | Professional | None | $977.24 | $1,380.38 | $2,630.27 |
12 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 $478.63 Median $478.63 Typical High $630.96 | Professional | 52 · Reduced service | $478.63 | $478.63 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $251.19 | Professional | 53 · Discontinued | $194.98 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $933.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $870.96 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,949.84 Typical High $4,168.69 | Professional | 50 · Both sides | $1,412.54 | $1,949.84 | $4,168.69 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $467.74 Median $645.65 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $467.74 | $645.65 | $1,412.54 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $257.04 Typical High $562.34 | Professional | 80 · Assistant surgeon | $190.55 | $257.04 | $562.34 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $181.97 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $131.83 | $181.97 | $389.05 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $181.97 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $181.97 | $389.05 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $181.97 Typical High $389.05 | Professional | AS · PA/NP assist | $131.83 | $181.97 | $389.05 |
Where North Carolina sits
The same service costs 4.7 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· 15th of 51
$1,660
AK $3,981TX $851
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.