How much rates vary
Facilitymedian $2,239 · 10th to 90th $550 to $14,125Professionalmedian $794 · 10th to 90th $550 to $1,380
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 $549.54 Median $1,288.25 Typical High $10,471.29 | Facility | None | $549.54 | $1,288.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $912.01 | Professional | None | $549.54 | $549.54 | $912.01 |
BCBS North Carolina Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,412.54 | Professional | None | $707.95 | $1,023.29 | $1,412.54 |
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 $549.54 Median $707.95 Typical High $1,412.54 | Professional | None | $549.54 | $707.95 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $660.69 Typical High $1,995.26 | Facility | None | $549.54 | $660.69 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $912.01 | Professional | None | $630.96 | $707.95 | $912.01 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,398.83 | $12,022.64 |
United Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,348.96 | Professional | None | $524.81 | $741.31 | $1,348.96 |
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 $275.42 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $407.38 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $426.58 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $354.81 Typical High $776.25 | Professional | 51 · Multiple procedures | $309.03 | $354.81 | $776.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $141.25 Typical High $309.03 | Professional | 80 · Assistant surgeon | $125.89 | $141.25 | $309.03 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $87.10 Median $97.72 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $87.10 | $97.72 | $218.78 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $87.10 Median $97.72 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $87.10 | $97.72 | $218.78 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $97.72 Typical High $218.78 | Professional | AS · PA/NP assist | $87.10 | $97.72 | $218.78 |
Where North Carolina sits
The same service costs 6.0 times more in Alaska than in Utah. 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· 20th of 51
$832
AK $2,239UT $372
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.