How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,820 · 10th to 90th $1,349 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 $1,230.27 Median $1,230.27 Typical High $7,943.28 | Facility | None | $1,230.27 | $1,230.27 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,230.27 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,238.72 | $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 $1,380.38 Median $1,778.28 Typical High $3,548.13 | Professional | None | $1,380.38 | $1,778.28 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $5,011.87 | Facility | None | $1,230.27 | $1,479.11 | $5,011.87 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,513.56 | $2,187.76 |
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 $1,258.93 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,258.93 | $1,778.28 | $3,311.31 |
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 $616.60 Median $616.60 Typical High $794.33 | Professional | 52 · Reduced service | $616.60 | $616.60 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $316.23 | Professional | 53 · Discontinued | $245.47 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,174.90 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $158.49 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,096.48 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,454.71 Typical High $5,370.32 | Professional | 50 · Both sides | $1,778.28 | $2,454.71 | $5,370.32 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $831.76 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $602.56 | $831.76 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $331.13 Typical High $707.95 | Professional | 80 · Assistant surgeon | $239.88 | $331.13 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $229.09 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $165.96 | $229.09 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $229.09 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $229.09 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $229.09 Typical High $501.19 | Professional | AS · PA/NP assist | $165.96 | $229.09 | $501.19 |
Where North Carolina sits
The same service costs 4.8 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· 27th of 51
$1,778
AK $5,012TX $1,047
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.