How much rates vary
Facilitymedian $912 · 10th to 90th $389 to $8,128Professionalmedian $1,479 · 10th to 90th $1,023 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 $912.01 Median $1,445.44 Typical High $10,715.19 | Facility | None | $912.01 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,819.70 | $2,570.40 |
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 $1,047.13 Median $1,318.26 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,318.26 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $3,890.45 | Facility | None | $912.01 | $1,096.48 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,288.25 | $1,621.81 |
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 $933.25 Median $1,202.26 Typical High $2,290.87 | Professional | None | $933.25 | $1,202.26 | $2,290.87 |
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 $457.09 Median $457.09 Typical High $575.44 | Professional | 52 · Reduced service | $457.09 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $794.33 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $1,949.84 Typical High $4,073.80 | Professional | 50 · Both sides | $1,778.28 | $1,949.84 | $4,073.80 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $645.65 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $588.84 | $645.65 | $1,348.96 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $257.04 Typical High $537.03 | Professional | 80 · Assistant surgeon | $239.88 | $257.04 | $537.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $181.97 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $165.96 | $181.97 | $380.19 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $181.97 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $181.97 | $380.19 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $181.97 Typical High $380.19 | Professional | AS · PA/NP assist | $165.96 | $181.97 | $380.19 |
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· 16th of 51
$1,479
AK $3,802TX $575
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.