How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,291 · 10th to 90th $1,479 to $3,715
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 $1,479.11 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,479.11 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,479.11 | $1,995.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,754.23 | $3,715.35 |
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 $1,737.80 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,737.80 | $2,238.72 | $3,801.89 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $2,398.83 | Facility | None | $1,258.93 | $1,479.11 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,995.26 | $2,398.83 |
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 $1,230.27 Median $2,137.96 Typical High $3,981.07 | Professional | None | $1,230.27 | $2,137.96 | $3,981.07 |
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 $741.31 Median $741.31 Typical High $977.24 | Professional | 52 · Reduced service | $741.31 | $741.31 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | 53 · Discontinued | $302.00 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $295.12 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $199.53 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $1,000.00 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $707.95 | $1,000.00 | $2,089.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $407.38 Typical High $831.76 | Professional | 80 · Assistant surgeon | $281.84 | $407.38 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $281.84 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $199.53 | $281.84 | $588.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $281.84 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $281.84 | $588.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $281.84 Typical High $588.84 | Professional | AS · PA/NP assist | $199.53 | $281.84 | $588.84 |
Where North Carolina sits
The same service costs 4.7 times more in Alaska than in Arkansas. 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· 18th of 51
$2,138
AK $6,166AR $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.