How much rates vary
Facilitymedian $1,995 · 10th to 90th $676 to $12,882Professionalmedian $1,479 · 10th to 90th $933 to $2,344
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 $891.25 Median $1,445.44 Typical High $10,715.19 | Facility | None | $891.25 | $1,445.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | None | $891.25 | $891.25 | $1,023.29 |
BCBS North Carolina Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,698.24 | $2,398.83 |
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 $1,023.29 Median $1,202.26 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,202.26 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,737.80 | Facility | None | $891.25 | $1,096.48 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,148.15 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $12,302.69 | Facility | None | $1,047.13 | $2,398.83 | $12,302.69 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $2,238.72 | Professional | None | $870.96 | $1,258.93 | $2,238.72 |
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 $446.68 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $707.95 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,737.80 Typical High $3,890.45 | Professional | 50 · Both sides | $1,659.59 | $1,737.80 | $3,890.45 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $575.44 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $549.54 | $575.44 | $1,288.25 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $229.09 Typical High $524.81 | Professional | 80 · Assistant surgeon | $218.78 | $229.09 | $524.81 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $162.18 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $154.88 | $162.18 | $363.08 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $162.18 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $162.18 | $363.08 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $162.18 Typical High $363.08 | Professional | AS · PA/NP assist | $154.88 | $162.18 | $363.08 |
Where North Carolina sits
The same service costs 6.3 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· 14th of 51
$1,479
AK $3,715UT $589
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.