How much rates vary
Facilitymedian $1,122 · 10th to 90th $389 to $8,318Professionalmedian $1,698 · 10th to 90th $724 to $3,090
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 $1,122.02 Median $1,584.89 Typical High $10,964.78 | Facility | None | $1,122.02 | $1,584.89 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,122.02 | $1,122.02 | $1,380.38 |
BCBS North Carolina Setting Professional Modifier None Typical Low $724.44 Median $2,137.96 Typical High $3,090.30 | Professional | None | $724.44 | $2,137.96 | $3,090.30 |
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 $1,258.93 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,621.81 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $4,570.88 | Facility | None | $1,122.02 | $1,348.96 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,548.82 | $1,949.84 |
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 $1,122.02 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,412.54 | $2,754.23 |
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 $562.34 Median $562.34 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $562.34 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $977.24 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $776.25 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $707.95 | $776.25 | $1,621.81 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $309.03 Typical High $660.69 | Professional | 80 · Assistant surgeon | $281.84 | $309.03 | $660.69 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $218.78 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $199.53 | $218.78 | $457.09 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $218.78 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $218.78 | $457.09 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $218.78 Typical High $457.09 | Professional | AS · PA/NP assist | $199.53 | $218.78 | $457.09 |
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· 17th of 51
$1,660
AK $4,571UT $794
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.