How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $7,244Professionalmedian $1,950 · 10th to 90th $1,202 to $3,467
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 $1,412.54 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,412.54 | $1,548.82 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,202.26 | $2,454.71 | $3,801.89 |
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 $1,479.11 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,479.11 | $1,819.70 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $4,466.84 | Facility | None | $1,412.54 | $1,659.59 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,698.24 | $2,290.87 |
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 $1,288.25 Median $1,862.09 Typical High $3,467.37 | Professional | None | $1,288.25 | $1,862.09 | $3,467.37 |
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 $691.83 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,096.48 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $812.83 Median $831.76 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $812.83 | $831.76 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $338.84 Typical High $794.33 | Professional | 80 · Assistant surgeon | $323.59 | $338.84 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $234.42 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $229.09 | $234.42 | $562.34 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $234.42 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $234.42 | $562.34 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $234.42 Typical High $562.34 | Professional | AS · PA/NP assist | $229.09 | $234.42 | $562.34 |
Where North Carolina sits
The same service costs 7.1 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· 21st of 51
$1,905
AK $5,754TX $813
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.