How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,660 · 10th to 90th $1,072 to $2,570
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 $1,071.52 Median $1,071.52 Typical High $7,943.28 | Facility | None | $1,071.52 | $1,071.52 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,071.52 | $1,318.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,905.46 | $2,884.03 |
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 $1,122.02 Median $1,380.38 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,380.38 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $4,073.80 | Facility | None | $1,071.52 | $1,288.25 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,318.26 | $1,737.80 |
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 $977.24 Median $1,288.25 Typical High $2,570.40 | Professional | None | $977.24 | $1,288.25 | $2,570.40 |
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 $537.03 Median $537.03 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $537.03 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | 53 · Discontinued | $213.80 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $794.33 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $131.83 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $912.01 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $1,995.26 Typical High $4,570.88 | Professional | 50 · Both sides | $1,905.46 | $1,995.26 | $4,570.88 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $660.69 Typical High $1,548.82 | Professional | 51 · Multiple procedures | $630.96 | $660.69 | $1,548.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $263.03 Typical High $616.60 | Professional | 80 · Assistant surgeon | $257.04 | $263.03 | $616.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $186.21 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $177.83 | $186.21 | $426.58 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $186.21 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $186.21 | $426.58 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $186.21 Typical High $426.58 | Professional | AS · PA/NP assist | $177.83 | $186.21 | $426.58 |
Where North Carolina sits
The same service costs 6.6 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· 15th of 51
$1,660
AK $4,365TX $661
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.