How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,905 · 10th to 90th $1,288 to $3,236
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 $1,202.26 Median $1,202.26 Typical High $7,943.28 | Facility | None | $1,202.26 | $1,202.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,202.26 | $1,479.11 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,584.89 | $2,344.23 | $3,311.31 |
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 $1,318.26 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,698.24 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $5,128.61 | Facility | None | $1,202.26 | $1,445.44 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,659.59 | $2,344.23 |
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 $1,202.26 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,513.56 | $2,951.21 |
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 $602.56 Median $602.56 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,047.13 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,511.89 Typical High $5,248.07 | Professional | 50 · Both sides | $2,238.72 | $2,511.89 | $5,248.07 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $831.76 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $758.58 | $831.76 | $1,737.80 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $331.13 Typical High $707.95 | Professional | 80 · Assistant surgeon | $302.00 | $331.13 | $707.95 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $234.42 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $208.93 | $234.42 | $489.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $234.42 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $234.42 | $489.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $234.42 Typical High $489.78 | Professional | AS · PA/NP assist | $208.93 | $234.42 | $489.78 |
Where North Carolina sits
The same service costs 5.9 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
$1,905
AK $4,898TX $832
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.