How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,570 · 10th to 90th $1,479 to $5,370
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 $2,137.96 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,137.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,137.96 | $2,691.53 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,479.11 Median $3,090.30 Typical High $5,888.44 | Professional | None | $1,479.11 | $3,090.30 | $5,888.44 |
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 $1,659.59 Median $2,630.27 Typical High $5,754.40 | Professional | None | $1,659.59 | $2,630.27 | $5,754.40 |
Medcost Setting Facility Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $5,754.40 | Facility | None | $2,137.96 | $2,511.89 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,778.28 | $1,949.84 | $3,388.44 |
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 $1,698.24 Median $2,398.83 Typical High $5,754.40 | Professional | None | $1,698.24 | $2,398.83 | $5,754.40 |
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 $1,047.13 Median $1,047.13 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | 53 · Discontinued | $426.58 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $407.38 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $269.15 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,905.46 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $977.24 Typical High $3,090.30 | Professional | 51 · Multiple procedures | $891.25 | $977.24 | $3,090.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $389.05 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $354.81 | $389.05 | $1,230.27 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $269.15 Typical High $851.14 | Professional | 81 · Minimal assistant surgeon | $245.47 | $269.15 | $851.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $269.15 Typical High $851.14 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $269.15 | $851.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $269.15 Typical High $851.14 | Professional | AS · PA/NP assist | $245.47 | $269.15 | $851.14 |
Where North Carolina sits
The same service costs 5.8 times more in Alaska than in Delaware. 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· 37th of 51
$2,344
AK $8,710DE $1,514
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.