How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $2,239 · 10th to 90th $1,549 to $4,074
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 $1,479.11 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,479.11 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,479.11 | $1,737.80 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $4,168.69 | Professional | None | $1,737.80 | $2,818.38 | $4,168.69 |
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 $1,659.59 Median $2,137.96 Typical High $3,981.07 | Professional | None | $1,659.59 | $2,137.96 | $3,981.07 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $6,165.95 | Facility | None | $1,479.11 | $1,778.28 | $6,165.95 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,089.30 | $2,630.27 |
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 $1,412.54 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,412.54 | $1,819.70 | $3,630.78 |
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 $741.31 Median $741.31 Typical High $870.96 | Professional | 52 · Reduced service | $741.31 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 53 · Discontinued | $295.12 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $263.03 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $173.78 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,230.27 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,047.13 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $933.25 | $1,047.13 | $2,187.76 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $416.87 Typical High $870.96 | Professional | 80 · Assistant surgeon | $371.54 | $416.87 | $870.96 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $288.40 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $257.04 | $288.40 | $602.56 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $288.40 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $288.40 | $602.56 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $288.40 Typical High $602.56 | Professional | AS · PA/NP assist | $257.04 | $288.40 | $602.56 |
Where North Carolina sits
The same service costs 6.0 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· 15th of 51
$2,138
AK $6,026TX $1,000
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.