How much rates vary
Facilitymedian $2,188 · 10th to 90th $646 to $14,125Professionalmedian $2,512 · 10th to 90th $1,445 to $3,715
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 $1,348.96 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,348.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,819.70 Median $2,630.27 Typical High $3,801.89 | Professional | None | $1,819.70 | $2,630.27 | $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 $1,949.84 Typical High $3,715.35 | Professional | None | $1,513.56 | $1,949.84 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $5,754.40 | Facility | None | $1,348.96 | $1,621.81 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,621.81 | $1,905.46 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,380.38 | $1,737.80 | $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 $676.08 Median $676.08 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,174.90 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $2,884.03 Typical High $6,025.60 | Professional | 50 · Both sides | $2,570.40 | $2,884.03 | $6,025.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $954.99 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $870.96 | $954.99 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $380.19 Typical High $794.33 | Professional | 80 · Assistant surgeon | $346.74 | $380.19 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $269.15 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $239.88 | $269.15 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $269.15 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $269.15 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $269.15 Typical High $562.34 | Professional | AS · PA/NP assist | $239.88 | $269.15 | $562.34 |
Where North Carolina sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$2,512
AK $5,623UT $977
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.