How much rates vary
Facilitymedian $1,047 · 10th to 90th $389 to $8,318Professionalmedian $2,089 · 10th to 90th $1,175 to $2,951
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 $1,047.13 Median $1,584.89 Typical High $11,481.54 | Facility | None | $1,047.13 | $1,584.89 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,047.13 | $1,318.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,412.54 | $2,238.72 | $2,951.21 |
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 $1,202.26 Median $1,513.56 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,513.56 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $4,265.80 | Facility | None | $1,047.13 | $1,258.93 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,445.44 | $1,819.70 |
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 $1,047.13 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,047.13 | $1,380.38 | $2,630.27 |
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 $524.81 Median $524.81 Typical High $660.69 | Professional | 52 · Reduced service | $524.81 | $524.81 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | 53 · Discontinued | $213.80 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $977.24 | Professional | 54 · Surgery only | $794.33 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $199.53 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $131.83 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $912.01 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $724.44 Typical High $1,548.82 | Professional | 51 · Multiple procedures | $691.83 | $724.44 | $1,548.82 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $288.40 Typical High $616.60 | Professional | 80 · Assistant surgeon | $275.42 | $288.40 | $616.60 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $204.17 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $194.98 | $204.17 | $436.52 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $204.17 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $204.17 | $436.52 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $204.17 Typical High $436.52 | Professional | AS · PA/NP assist | $194.98 | $204.17 | $436.52 |
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· 11th of 51
$1,995
AK $4,365TX $741
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.