How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,148 to $8,318Professionalmedian $2,188 · 10th to 90th $1,230 to $3,548
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 $1,148.15 Median $1,479.11 Typical High $10,000.00 | Facility | None | $1,148.15 | $1,479.11 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,479.11 | $1,548.82 |
BCBS North Carolina Setting Facility Modifier None Typical Low $2,398.83 Median $3,548.13 Typical High $4,786.30 | Facility | None | $2,398.83 | $3,548.13 | $4,786.30 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,548.82 | $2,454.71 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $6,025.60 | Facility | None | $912.01 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,258.93 | $1,584.89 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,905.46 Typical High $4,265.80 | Facility | None | $831.76 | $1,905.46 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,659.59 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $15,848.93 | Facility | None | $1,202.26 | $3,311.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $3,388.44 | Professional | None | $1,174.90 | $1,584.89 | $3,388.44 |
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 $575.44 Median $691.83 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $229.09 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,047.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $851.14 | $1,047.13 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $114.82 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $977.24 | $1,071.52 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $416.87 Median $1,000.00 Typical High $2,884.03 | Facility | 51 · Multiple procedures | $416.87 | $1,000.00 | $2,884.03 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $831.76 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $616.60 | $831.76 | $2,089.30 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $338.84 Typical High $831.76 | Professional | 80 · Assistant surgeon | $245.47 | $338.84 | $831.76 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $234.42 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $173.78 | $234.42 | $588.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $234.42 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $234.42 | $588.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $234.42 Typical High $588.84 | Professional | AS · PA/NP assist | $173.78 | $234.42 | $588.84 |
Where North Carolina sits
The same service costs 5.2 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· 13th of 51
$2,188
AK $6,026TX $1,148
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.