How much rates vary
Facilitymedian $871 · 10th to 90th $398 to $7,079Professionalmedian $513 · 10th to 90th $339 to $851
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 $331.13 Median $1,148.15 Typical High $7,943.28 | Facility | None | $331.13 | $1,148.15 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $562.34 | Professional | None | $331.13 | $331.13 | $562.34 |
BCBS North Carolina Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $870.96 | Professional | None | $436.52 | $616.60 | $870.96 |
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 $371.54 Median $436.52 Typical High $870.96 | Professional | None | $371.54 | $436.52 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $933.25 | Facility | None | $331.13 | $398.11 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $741.31 | Professional | None | $398.11 | $467.74 | $741.31 |
United Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $4,365.16 | Facility | None | $478.63 | $831.76 | $4,365.16 |
United Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $831.76 | Professional | None | $323.59 | $457.09 | $831.76 |
12 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 $165.96 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $263.03 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 79 · Unrelated procedure after surgery | $407.38 | $407.38 | $407.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $263.03 Typical High $478.63 | Professional | 51 · Multiple procedures | $204.17 | $263.03 | $478.63 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $104.71 Typical High $190.55 | Professional | 80 · Assistant surgeon | $83.18 | $104.71 | $190.55 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $74.13 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $57.54 | $74.13 | $131.83 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $74.13 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $74.13 | $131.83 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $74.13 Typical High $131.83 | Professional | AS · PA/NP assist | $57.54 | $74.13 | $131.83 |
Where North Carolina sits
The same service costs 5.8 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· 19th of 51
$525
AK $1,380UT $240
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.