How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,692 · 10th to 90th $1,778 to $4,365
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 $1,778.28 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,778.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,778.28 | $1,778.28 | $2,511.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,995.26 Median $3,311.31 Typical High $4,365.16 | Professional | None | $1,995.26 | $3,311.31 | $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 $2,089.30 Median $2,691.53 Typical High $4,570.88 | Professional | None | $2,089.30 | $2,691.53 | $4,570.88 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,884.03 | Facility | None | $1,479.11 | $1,778.28 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,884.03 | Professional | None | $1,698.24 | $2,398.83 | $2,884.03 |
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 $1,445.44 Median $2,454.71 Typical High $4,897.79 | Professional | None | $1,445.44 | $2,454.71 | $4,897.79 |
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 $891.25 Median $891.25 Typical High $1,174.90 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $478.63 | Professional | 53 · Discontinued | $354.81 | $354.81 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $239.88 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $239.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $1,202.26 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $851.14 | $1,202.26 | $2,511.89 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $489.78 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $338.84 | $489.78 | $1,000.00 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $338.84 Typical High $707.95 | Professional | 81 · Minimal assistant surgeon | $239.88 | $338.84 | $707.95 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $338.84 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $338.84 | $707.95 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $338.84 Typical High $707.95 | Professional | AS · PA/NP assist | $239.88 | $338.84 | $707.95 |
Where North Carolina sits
The same service costs 4.7 times more in Alaska than in South Carolina. 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· 25th of 51
$2,512
AK $7,413SC $1,585
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.