How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,905 · 10th to 90th $1,349 to $3,631
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 $1,348.96 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,348.96 | $2,290.87 | $3,801.89 |
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 $1,819.70 Typical High $3,311.31 | Professional | None | $1,513.56 | $1,819.70 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $5,128.61 | Facility | None | $1,202.26 | $1,445.44 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,698.24 | $2,630.27 |
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 $3,311.31 | Professional | None | $1,230.27 | $1,862.09 | $3,311.31 |
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 $602.56 Median $602.56 Typical High $776.25 | Professional | 52 · Reduced service | $602.56 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $309.03 | Professional | 53 · Discontinued | $239.88 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,148.15 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,071.52 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $870.96 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $630.96 | $870.96 | $1,778.28 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $346.74 Typical High $707.95 | Professional | 80 · Assistant surgeon | $257.04 | $346.74 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $245.47 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $177.83 | $245.47 | $501.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $245.47 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $245.47 | $501.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $245.47 Typical High $501.19 | Professional | AS · PA/NP assist | $177.83 | $245.47 | $501.19 |
Where North Carolina sits
The same service costs 5.5 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
$1,820
AK $4,898TX $891
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.