How much rates vary
Facilitymedian $871 · 10th to 90th $380 to $7,244Professionalmedian $1,318 · 10th to 90th $933 to $2,344
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 $870.96 Median $870.96 Typical High $7,943.28 | Facility | None | $870.96 | $870.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,071.52 | Professional | None | $870.96 | $870.96 | $1,071.52 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,659.59 | $2,398.83 |
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 $954.99 Median $1,230.27 Typical High $2,344.23 | Professional | None | $954.99 | $1,230.27 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,047.13 Typical High $3,548.13 | Facility | None | $870.96 | $1,047.13 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,202.26 | $1,513.56 |
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 $870.96 Median $1,096.48 Typical High $2,187.76 | Professional | None | $870.96 | $1,096.48 | $2,187.76 |
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 $436.52 Median $436.52 Typical High $537.03 | Professional | 52 · Reduced service | $436.52 | $436.52 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $812.83 | Professional | 54 · Surgery only | $645.65 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $162.18 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $107.15 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $758.58 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,819.70 Typical High $3,801.89 | Professional | 50 · Both sides | $1,621.81 | $1,819.70 | $3,801.89 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $602.56 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $537.03 | $602.56 | $1,258.93 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $239.88 Typical High $512.86 | Professional | 80 · Assistant surgeon | $218.78 | $239.88 | $512.86 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $169.82 Typical High $354.81 | Professional | 81 · Minimal assistant surgeon | $151.36 | $169.82 | $354.81 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $169.82 Typical High $354.81 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $169.82 | $354.81 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $169.82 Typical High $354.81 | Professional | AS · PA/NP assist | $151.36 | $169.82 | $354.81 |
Where North Carolina sits
The same service costs 5.6 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· 16th of 51
$1,318
AK $3,548UT $631
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.