How much rates vary
Facilitymedian $1,995 · 10th to 90th $676 to $12,882Professionalmedian $1,096 · 10th to 90th $708 to $1,820
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 $707.95 Median $1,288.25 Typical High $8,317.64 | Facility | None | $707.95 | $1,288.25 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $794.33 | Professional | None | $707.95 | $707.95 | $794.33 |
BCBS North Carolina Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,862.09 | Professional | None | $891.25 | $1,318.26 | $1,862.09 |
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 $707.95 Median $912.01 Typical High $1,819.70 | Professional | None | $707.95 | $912.01 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,148.15 | Facility | None | $707.95 | $724.44 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,174.90 | Professional | None | $676.08 | $912.01 | $1,174.90 |
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 $707.95 Median $954.99 Typical High $1,737.80 | Professional | None | $707.95 | $954.99 | $1,737.80 |
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 $354.81 Median $354.81 Typical High $398.11 | Professional | 52 · Reduced service | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $549.54 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,380.38 Typical High $3,019.95 | Professional | 50 · Both sides | $1,023.29 | $1,380.38 | $3,019.95 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $457.09 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $338.84 | $457.09 | $1,023.29 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $181.97 Typical High $407.38 | Professional | 80 · Assistant surgeon | $134.90 | $181.97 | $407.38 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $95.50 Median $128.82 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $95.50 | $128.82 | $281.84 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $128.82 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $128.82 | $281.84 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $128.82 Typical High $281.84 | Professional | AS · PA/NP assist | $95.50 | $128.82 | $281.84 |
Where North Carolina sits
The same service costs 6.9 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· 16th of 51
$1,096
AK $2,884TX $417
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.