How much rates vary
Facilitymedian $1,585 · 10th to 90th $646 to $10,233Professionalmedian $1,175 · 10th to 90th $794 to $2,089
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 $741.31 Median $1,288.25 Typical High $8,317.64 | Facility | None | $741.31 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,096.48 | Professional | None | $741.31 | $741.31 | $1,096.48 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,513.56 | $2,089.30 |
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 $812.83 Median $1,071.52 Typical High $1,995.26 | Professional | None | $812.83 | $1,071.52 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $891.25 Typical High $2,951.21 | Facility | None | $741.31 | $891.25 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,288.25 | Professional | None | $891.25 | $1,023.29 | $1,288.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $8,709.64 | Facility | None | $851.14 | $1,698.24 | $8,709.64 |
United Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,862.09 | Professional | None | $741.31 | $954.99 | $1,862.09 |
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 $371.54 Median $371.54 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $691.83 | Professional | 54 · Surgery only | $562.34 | $562.34 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $138.04 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $645.65 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $512.86 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $457.09 | $512.86 | $1,096.48 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $204.17 Typical High $436.52 | Professional | 80 · Assistant surgeon | $181.97 | $204.17 | $436.52 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $141.25 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $128.82 | $141.25 | $309.03 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $141.25 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $141.25 | $309.03 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $141.25 Typical High $309.03 | Professional | AS · PA/NP assist | $128.82 | $141.25 | $309.03 |
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· 19th of 51
$1,175
AK $3,090TX $525
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.