How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,089 · 10th to 90th $1,445 to $4,074
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 $1,412.54 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,412.54 | $1,819.70 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $4,265.80 | Professional | None | $1,445.44 | $2,570.40 | $4,265.80 |
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 $1,548.82 Median $2,041.74 Typical High $3,801.89 | Professional | None | $1,548.82 | $2,041.74 | $3,801.89 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $5,370.32 | Facility | None | $1,412.54 | $1,698.24 | $5,370.32 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,698.24 | $2,344.23 |
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 $2,041.74 Typical High $3,801.89 | Professional | None | $1,412.54 | $2,041.74 | $3,801.89 |
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 $707.95 Median $707.95 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $181.97 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,258.93 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,818.38 Typical High $6,165.95 | Professional | 50 · Both sides | $2,041.74 | $2,818.38 | $6,165.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $933.25 Typical High $2,041.74 | Professional | 51 · Multiple procedures | $676.08 | $933.25 | $2,041.74 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $371.54 Typical High $812.83 | Professional | 80 · Assistant surgeon | $269.15 | $371.54 | $812.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $263.03 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $190.55 | $263.03 | $575.44 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $263.03 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $263.03 | $575.44 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $263.03 Typical High $575.44 | Professional | AS · PA/NP assist | $190.55 | $263.03 | $575.44 |
Where North Carolina sits
The same service costs 5.6 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· 22nd of 51
$2,042
AK $5,754TX $1,023
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.