How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $3,090 · 10th to 90th $1,698 to $4,365
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 $1,584.89 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,584.89 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,584.89 | $1,995.26 |
BCBS North Carolina Setting Professional Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $4,466.84 | Professional | None | $2,137.96 | $3,467.37 | $4,466.84 |
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 $1,862.09 Median $2,290.87 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,290.87 | $4,365.16 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $6,760.83 | Facility | None | $1,584.89 | $1,905.46 | $6,760.83 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,584.89 | $2,187.76 | $2,691.53 |
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 $1,584.89 Median $2,041.74 Typical High $3,981.07 | Professional | None | $1,584.89 | $2,041.74 | $3,981.07 |
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 $794.33 Median $794.33 Typical High $1,000.00 | Professional | 52 · Reduced service | $794.33 | $794.33 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $398.11 | Professional | 53 · Discontinued | $323.59 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $302.00 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $199.53 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,412.54 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,096.48 Typical High $2,344.23 | Professional | 51 · Multiple procedures | $1,071.52 | $1,096.48 | $2,344.23 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $436.52 Typical High $933.25 | Professional | 80 · Assistant surgeon | $426.58 | $436.52 | $933.25 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $302.00 Median $309.03 Typical High $660.69 | Professional | 81 · Minimal assistant surgeon | $302.00 | $309.03 | $660.69 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $302.00 Median $309.03 Typical High $660.69 | Professional | 82 · Assistant surgeon, no resident | $302.00 | $309.03 | $660.69 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $309.03 Typical High $660.69 | Professional | AS · PA/NP assist | $302.00 | $309.03 | $660.69 |
Where North Carolina sits
The same service costs 6.8 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· 9th of 51
$2,951
AK $6,607TX $977
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.