How much rates vary
Facilitymedian $977 · 10th to 90th $355 to $2,239Professionalmedian $1,230 · 10th to 90th $851 to $2,399
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 $758.58 Median $758.58 Typical High $7,943.28 | Facility | None | $758.58 | $758.58 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,071.52 | Professional | None | $758.58 | $758.58 | $1,071.52 |
BCBS North Carolina Setting Facility Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,737.80 | Facility | None | $851.14 | $1,258.93 | $1,737.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $851.14 Median $1,412.54 Typical High $2,570.40 | Professional | None | $851.14 | $1,412.54 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $977.24 Typical High $1,737.80 | Facility | None | $602.56 | $977.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $2,344.23 | Professional | None | $933.25 | $1,230.27 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,230.27 Typical High $2,041.74 | Facility | None | $794.33 | $1,230.27 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,479.11 | Professional | None | $851.14 | $1,047.13 | $1,479.11 |
United Setting Facility Modifier None Typical Low $288.40 Median $501.19 Typical High $2,754.23 | Facility | None | $288.40 | $501.19 | $2,754.23 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,089.30 | Professional | None | $870.96 | $1,230.27 | $2,089.30 |
11 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 $380.19 Median $380.19 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $741.31 | Professional | 54 · Surgery only | $575.44 | $575.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $691.83 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $426.58 Median $575.44 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $426.58 | $575.44 | $1,122.02 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $234.42 Typical High $446.68 | Professional | 80 · Assistant surgeon | $169.82 | $234.42 | $446.68 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $117.49 Median $162.18 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $117.49 | $162.18 | $316.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $117.49 Median $162.18 Typical High $316.23 | Professional | 82 · Assistant surgeon, no resident | $117.49 | $162.18 | $316.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $162.18 Typical High $316.23 | Professional | AS · PA/NP assist | $117.49 | $162.18 | $316.23 |
Where North Carolina sits
The same service costs 4.4 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
$1,202
AK $3,020TX $692
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.