How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,291 · 10th to 90th $1,349 to $3,311
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 $1,202.26 Median $1,202.26 Typical High $7,943.28 | Facility | None | $1,202.26 | $1,202.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,202.26 | $1,548.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,778.28 | $2,454.71 | $3,388.44 |
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 $1,513.56 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,778.28 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,454.71 | Facility | None | $1,202.26 | $1,445.44 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,905.46 | $2,570.40 |
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 $1,862.09 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,862.09 | $3,235.94 |
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 $602.56 Median $602.56 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,071.52 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $3,235.94 Typical High $5,248.07 | Professional | 50 · Both sides | $1,698.24 | $3,235.94 | $5,248.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $562.34 Median $1,096.48 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $562.34 | $1,096.48 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $436.52 Typical High $691.83 | Professional | 80 · Assistant surgeon | $223.87 | $436.52 | $691.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $302.00 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $158.49 | $302.00 | $489.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $302.00 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $302.00 | $489.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $302.00 Typical High $489.78 | Professional | AS · PA/NP assist | $158.49 | $302.00 | $489.78 |
Where North Carolina sits
The same service costs 5.4 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· 12th of 51
$2,188
AK $4,898TX $912
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.