How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,762Professionalmedian $3,236 · 10th to 90th $2,188 to $5,623
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 $2,041.74 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,041.74 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,041.74 | $2,570.40 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,754.23 Median $3,981.07 Typical High $5,754.40 | Professional | None | $2,754.23 | $3,981.07 | $5,754.40 |
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 $2,238.72 Median $2,951.21 Typical High $5,495.41 | Professional | None | $2,238.72 | $2,951.21 | $5,495.41 |
Medcost Setting Facility Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $8,128.31 | Facility | None | $2,041.74 | $2,454.71 | $8,128.31 |
Medcost Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,454.71 | $2,884.03 | $3,548.13 |
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 $2,089.30 Median $2,630.27 Typical High $5,128.61 | Professional | None | $2,089.30 | $2,630.27 | $5,128.61 |
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 $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $512.86 | Professional | 53 · Discontinued | $407.38 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $380.19 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $257.04 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,778.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,258.93 Median $1,445.44 Typical High $3,019.95 | Professional | 51 · Multiple procedures | $1,258.93 | $1,445.44 | $3,019.95 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $575.44 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $501.19 | $575.44 | $1,202.26 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $407.38 Typical High $851.14 | Professional | 81 · Minimal assistant surgeon | $346.74 | $407.38 | $851.14 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $407.38 Typical High $851.14 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $407.38 | $851.14 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $407.38 Typical High $851.14 | Professional | AS · PA/NP assist | $346.74 | $407.38 | $851.14 |
Where North Carolina sits
The same service costs 6.2 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· 14th of 51
$3,236
AK $8,511TX $1,380
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.