How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,512 · 10th to 90th $1,820 to $5,129
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 $1,698.24 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,698.24 | $1,698.24 | $2,137.96 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,819.70 Median $3,090.30 Typical High $5,128.61 | Professional | None | $1,819.70 | $3,090.30 | $5,128.61 |
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 $1,995.26 Median $2,511.89 Typical High $4,677.35 | Professional | None | $1,995.26 | $2,511.89 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $4,786.30 | Facility | None | $1,698.24 | $2,041.74 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,041.74 | $2,691.53 |
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 $1,737.80 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,737.80 | $2,511.89 | $4,570.88 |
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 $851.14 Median $851.14 Typical High $1,071.52 | Professional | 52 · Reduced service | $851.14 | $851.14 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $426.58 | Professional | 53 · Discontinued | $338.84 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $323.59 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,513.56 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $3,467.37 Typical High $7,413.10 | Professional | 50 · Both sides | $2,511.89 | $3,467.37 | $7,413.10 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $1,148.15 Typical High $2,454.71 | Professional | 51 · Multiple procedures | $831.76 | $1,148.15 | $2,454.71 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $457.09 Typical High $977.24 | Professional | 80 · Assistant surgeon | $331.13 | $457.09 | $977.24 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $323.59 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $234.42 | $323.59 | $691.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $323.59 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $323.59 | $691.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $323.59 Typical High $691.83 | Professional | AS · PA/NP assist | $234.42 | $323.59 | $691.83 |
Where North Carolina sits
The same service costs 5.8 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· 22nd of 51
$2,455
AK $6,918TX $1,202
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.